Organization
PRIME PODIATRIC GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN JAY PIRAK DPM (CEO/OWNER)
(818) 488-6076
Entity
Organization
Contact information
Practice address
10916 RIVERSIDE DR, TOLUCA LAKE, CA 91602-2210
(818) 488-6076
(818) 210-0281
Mailing address
10916 RIVERSIDE DR, TOLUCA LAKE, CA 91602-2210
(818) 488-6076
(818) 210-0281
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
02/02/2024
Last updated
04/17/2024
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