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General NPI Number Information
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NPI Number | 1316645351
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Entity Type | Organization
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Legal Business Name | SUCHIR SHETH PODIATRY CORPORATION
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 2001 SANTA MONICA BLVD STE 465W
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City | SANTA MONICA
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State | CA
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Zip | 90404-2178
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Country | US
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Telephone | 310-396-5025
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Fax | 888-798-0180
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Provider Business Mailing Address
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Address Line | 2001 SANTA MONICA BLVD STE 465W
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City | SANTA MONICA
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State | CA
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Zip | 90404-2178
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Country | US
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Telephone | 310-396-5025
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Fax | 888-798-0180
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUCHIR KETAN SHETH
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Credential | DPM
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Telephone | 717-250-9383
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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 |
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License Number State |
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