Healthcare Provider Details

I. General information

NPI: 1275026478
Provider Name (Legal Business Name): A STEP ABOVE FOOTCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3816 WOODRUFF AVE STE 302
LONG BEACH CA
90808-2146
US

IV. Provider business mailing address

3816 WOODRUFF AVE STE 302
LONG BEACH CA
90808-2146
US

V. Phone/Fax

Practice location:
  • Phone: 562-429-5300
  • Fax: 562-429-0535
Mailing address:
  • Phone: 562-429-5300
  • Fax: 562-429-0535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARJORIE J KHAWAM
Title or Position: OWNER
Credential: DPM
Phone: 562-429-5300