Individual
JOEL A AMMONS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
323 N PRAIRIE AVE, SUITE 320, INGLEWOOD, CA 90301-4502
(310) 671-8065
(310) 671-5810
Mailing address
PO BOX 1274, CULVER CITY, CA 90232-1274
(310) 671-8065
(310) 671-5810
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
E3561
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5537360001
MEDICARE DME
CA
01
—
E3561
LICENSE NUMBER
CA
05
—
OOOE35610
—
CA
Enumeration date
01/03/2007
Last updated
09/17/2010
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