Organization
INNOVATIVE FOOT AND ANKLE CARE, PC
Active
Other names
Innovative Foot and Ankle Care
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT KIM DPM (OWNER)
(909) 500-3007
Entity
Organization
Contact information
Practice address
8283 GROVE AVE STE 106, RANCHO CUCAMONGA, CA 91730-3139
(909) 500-3007
Mailing address
8283 GROVE AVE STE 106, RANCHO CUCAMONGA, CA 91730-3139
(909) 500-3007
(909) 530-3007
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
213EP0504X
Public Medicine Podiatrist
—
—
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
213ES0000X
Sports Medicine Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
261QP1100X
Podiatric Clinic/Center
—
—
Other
Enumeration date
12/28/2017
Last updated
01/07/2022
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