Organization
MICHAEL I CORNFIELD DPM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL I CORNFIELD MD (OWNER)
(714) 990-4422
Entity
Organization
Contact information
Practice address
410 W CENTRAL AVE, 204, BREA, CA 92821-3014
(714) 990-4422
(714) 990-2855
Mailing address
410 W CENTRAL AVE, 204, BREA, CA 92821-3014
(714) 990-4422
(714) 990-2855
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E2059
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00E2059
—
CA
01
—
1194745471
INDIVIDUAL NPI
CA
01
—
1609107366
NPI TYPE 2
CA
01
—
CV970Z
PTAN
CA
Enumeration date
01/20/2010
Last updated
04/01/2010
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