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General NPI Number Information
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NPI Number | 1144174541
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Entity Type | Organization
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Legal Business Name | JS PODIATRY & WOUND CARE, PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 02/23/2026
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Provider Practice Location Address
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Address Line | 7067 CAMINO REVUELTOS 314
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City | SAN DIEGO
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State | CA
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Zip | 92111
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Country | US
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Telephone | 310-625-7188
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Fax |
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Provider Business Mailing Address
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Address Line | 7067 CAMINO REVUELTOS UNIT 314
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City | SAN DIEGO
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State | CA
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Zip | 92111-7695
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Country | US
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Telephone | 310-625-7188
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JULIA V SOUVOROVA
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Credential | DPM
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Telephone | 310-625-7188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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