Healthcare Provider Details

I. General information

NPI: 1285646034
Provider Name (Legal Business Name): SUSAN HEIDI KIRKPATRICK DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 E HUNTINGTON DR
ARCADIA CA
91006-3209
US

IV. Provider business mailing address

PO BOX 1695
ARCADIA CA
91077-1695
US

V. Phone/Fax

Practice location:
  • Phone: 626-574-7592
  • Fax: 626-447-3704
Mailing address:
  • Phone: 626-574-7592
  • Fax: 626-447-3704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE3748
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: