Organization
PRO FOOT AND ANKLE CLINIC.INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUKE S WON DPM (DPM/PRESIDENT)
(510) 502-6046
Entity
Organization
Contact information
Practice address
9896 GARDEN GROVE BLVD, GARDEN GROVE, CA 92844-1643
(714) 636-3032
Mailing address
9896 GARDEN GROVE BLVD, GARDEN GROVE, CA 92844-1643
(714) 636-3032
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E5409
PODIATRY
CA
Enumeration date
06/21/2019
Last updated
06/21/2019
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