Organization
MICHAEL GODDARD L DPM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL GODDARD D.P.M. (PRESIDENT)
(714) 542-0656
Entity
Organization
Contact information
Practice address
1401 N. TUSTIN AVE, SUITE 130, SANTA ANA, CA 92705-8675
(714) 542-0656
Mailing address
1401 N. TUSTIN AVE, SUITE 130, SANTA ANA, CA 92705-8675
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4398
CA
Other
Enumeration date
01/25/2007
Last updated
06/21/2018
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