Individual
MR. MARK T KIDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
10 CONGRESS ST, #410, PASADENA, CA 91105
(626) 799-1194
(626) 449-9862
Mailing address
10 CONGRESS ST, STE 410, PASADENA, CA 91105-3045
(626) 799-1194
(626) 449-9862
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E3196
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00E1960
—
CA
01
—
E3196
STATE LICENSE
CA
Enumeration date
08/16/2006
Last updated
02/12/2008
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