Organization
MICHAEL W HEASLET DPM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GAIL KATHLEEN HEASLET (CORPORATE SECRETARY)
(949) 651-1202
Entity
Organization
Contact information
Practice address
4950 BARRANCA PKWY, SUITE 308, IRVINE, CA 92604-4671
(949) 651-1202
(949) 552-9493
Mailing address
4950 BARRANCA PKWY, SUITE 308, IRVINE, CA 92604-4671
(949) 651-1202
(949) 552-9493
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E2056
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790735397
TYPE 1 NPI
—
Enumeration date
11/01/2010
Last updated
11/01/2010
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