Individual
DR. MICHAEL LYNN WACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
3100 E FLORENCE AVE STE 4, HUNTINGTON PARK, CA 90255-5848
(323) 749-6950
(323) 749-6951
Mailing address
3100 E FLORENCE AVE, STE 4, HUNTINGTON PARK, CA 90255-5848
(323) 749-6950
(323) 749-6951
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
E4125
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E41250
—
CA
Enumeration date
06/27/2006
Last updated
02/23/2021
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