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General NPI Number Information
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NPI Number | 1518326008
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Entity Type | Organization
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Legal Business Name | ADVANCED CARING PODIATRY PC
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Dates
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Enumeration Date | 02/12/2016
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Last Update Date | 02/12/2016
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Provider Practice Location Address
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Address Line | 4929 WILSHIRE BLVD SUITE 720
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City | LOS ANGELES
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State | CA
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Zip | 90010-3808
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Country | US
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Telephone | 323-833-1092
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Fax |
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Provider Business Mailing Address
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Address Line | 4929 WILSHIRE BLVD SUITE 720
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City | LOS ANGELES
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State | CA
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Zip | 90010-3808
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NATHAN WEISS
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Credential |
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Telephone | 323-833-8334
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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 | C3864643
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License Number State | CA
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