Healthcare Provider Details

I. General information

NPI: 1104149269
Provider Name (Legal Business Name): CURE4FEET PODIATRY GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2010
Last Update Date: 07/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5907 LANKERSHIM BLVD
NORTH HOLLYWOOD CA
91601-1006
US

IV. Provider business mailing address

5907 LANKERSHIM BLVD
NORTH HOLLYWOOD CA
91601-1006
US

V. Phone/Fax

Practice location:
  • Phone: 818-980-3073
  • Fax: 866-818-0816
Mailing address:
  • Phone: 818-980-3073
  • Fax: 866-818-0816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4721
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4237
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5130
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1927
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4839
License Number StateCA

VIII. Authorized Official

Name: DR. KHANH T DUONG
Title or Position: PRESIDENT/DPM
Credential: DPM
Phone: 714-697-9939