Individual
MADISON RAVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
3405 KENYON ST STE 502, SAN DIEGO, CA 92110-5008
(619) 225-9601
Mailing address
3405 KENYON ST STE 502, SAN DIEGO, CA 92110-5008
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
1516
MA
Other
Enumeration date
04/08/2020
Last updated
03/06/2024
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