Organization
MIKE C JOU DPM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIKE C JOU D.P.M. (CEO)
(626) 820-0924
Entity
Organization
Contact information
Practice address
501 N HARBOR BLVD, LA HABRA, CA 90631-4060
(626) 820-0924
(626) 820-0925
Mailing address
501 N HARBOR BLVD, LA HABRA, CA 90631-4060
(626) 820-0924
(626) 820-0925
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
E4187
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E41870
—
CA
05
—
5720332
—
CA
01
—
W20188
MEDICARE GROUP ID
CA
Enumeration date
10/25/2006
Last updated
03/21/2018
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