Individual
STANLEY K. MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1701 E CESAR E CHAVEZ AVE, SUITE #510, LOS ANGELES, CA 90033-2464
(323) 987-1362
(323) 987-1365
Mailing address
1701 E CESAR E CHAVEZ AVE, STE 510, LOS ANGELES, CA 90033-2488
(323) 987-1362
(323) 987-1365
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3598
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E35980
—
CA
Enumeration date
07/26/2006
Last updated
06/28/2018
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