Healthcare Provider Details

I. General information

NPI: 1942135165
Provider Name (Legal Business Name): SUCHIR SHETH PODIATRY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 W LA PALMA AVE STE 100
ANAHEIM CA
92801-3661
US

IV. Provider business mailing address

2001 SANTA MONICA BLVD STE 465W
SANTA MONICA CA
90404-2178
US

V. Phone/Fax

Practice location:
  • Phone: 714-774-1550
  • Fax: 714-774-0601
Mailing address:
  • Phone: 310-396-5025
  • Fax: 888-798-0180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: SUCHIR KETAN SHETH
Title or Position: PRESIDENT
Credential:
Phone: 717-250-9383