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General NPI Number Information
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NPI Number | 1053362608
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Entity Type | Organization
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Legal Business Name | AMERICAN PODIATRY CORPORATION
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3906 W BURBANK BLVD
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City | BURBANK
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State | CA
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Zip | 91505-2117
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Country | US
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Telephone | 818-238-9892
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Fax |
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Provider Business Mailing Address
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Address Line | 3906 W BURBANK BLVD
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City | BURBANK
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State | CA
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Zip | 91505-2117
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Country | US
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Telephone | 818-238-9892
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | JONATHAN TORREGOSA TIONGSON
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Credential | DPM
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Telephone | 818-238-9892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E4600
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License Number State | CA
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