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General NPI Number Information
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NPI Number | 1134630981
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Entity Type | Organization
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Legal Business Name | HUNTINGTON FOOT & ANKLE CARE, INC.
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Dates
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Enumeration Date | 10/19/2017
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 12062 VALLEY VIEW ST STE 131
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City | GARDEN GROVE
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State | CA
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Zip | 92845-1741
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Country | US
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Telephone | 714-465-2178
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Fax | 714-465-2179
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Provider Business Mailing Address
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Address Line | 12062 VALLEY VIEW ST STE 131
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City | GARDEN GROVE
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State | CA
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Zip | 92845-1741
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Country | US
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Telephone | 714-465-2178
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Fax | 714-465-2179
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Authorized Official
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Title or Position | PODIATRIST/OWNER
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Name | CONG THANH MAI
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Credential | DPM
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Telephone | 714-465-2178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | A300277
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License Number State | CA
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