Individual
DR. ALLEN JEROME DEGRANDMONT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
188 E 17TH ST, SUITE #101, COSTA MESA, CA 92627-3763
(949) 646-7110
(949) 646-3957
Mailing address
188 E 17TH ST, SUITE #101, COSTA MESA, CA 92627-3763
(949) 646-7110
(949) 646-3957
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E1767
CA
Other
Enumeration date
05/04/2006
Last updated
07/08/2007
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