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General NPI Number Information
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NPI Number | 1346339330
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Entity Type | Organization
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Legal Business Name | EUCLID FOOT CLINIC PODIATRY GROUP, INC.
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 2621 S BRISTOL ST STE 209
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City | SANTA ANA
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State | CA
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Zip | 92704-5719
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Country | US
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Telephone | 714-850-1300
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Fax | 714-850-1301
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Provider Business Mailing Address
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Address Line | PO BOX 8877
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92728-8877
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Country | US
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Telephone | 714-850-1300
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Fax | 714-850-1301
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Authorized Official
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Title or Position | OWNER
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Name | PAUL Y. HAN
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Credential | DPM
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Telephone | 714-850-1300
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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 | E3270
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License Number State | CA
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