Organization
MARK T KIDON DPM FACFAS A PODIATRY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK T KIDON DPM (PRESIDENT)
(626) 799-1194
Entity
Organization
Contact information
Practice address
10 CONGRESS ST, STE 410, PASADENA, CA 91105-3045
(626) 799-1194
(626) 449-9862
Mailing address
10 CONGRESS ST, STE 410, PASADENA, CA 91105-3045
(626) 799-1194
(626) 449-9862
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E3196
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E31960
—
CA
Enumeration date
05/15/2007
Last updated
05/08/2018
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