Organization
COAST TO COAST FOOT DOCTORS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK R SHELLY MD (OWNER)
(661) 618-8081
Entity
Organization
Contact information
Practice address
18740 VENTURA BLVD STE 102, TARZANA, CA 91356-6353
(661) 618-8081
Mailing address
18740 VENTURA BLVD STE 102, TARZANA, CA 91356-6353
(818) 708-7668
(818) 708-9668
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Enumeration date
03/23/2023
Last updated
01/19/2024
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