Organization
MICHAELBASTANIDPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BASTANI DPM (OWNER)
(917) 675-1045
Entity
Organization
Contact information
Practice address
22 ODYSSEY STE 115, IRVINE, CA 92618-3188
(424) 256-8956
Mailing address
23785 EL TORO RD # 450, LAKE FOREST, CA 92630-4762
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
01/08/2020
Last updated
01/08/2020
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