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General NPI Number Information
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NPI Number | 1598812786
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Entity Type | Individual
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Provider Name | JOEL A AMMONS III D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 09/17/2010
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Provider Practice Location Address
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Address Line | 323 N PRAIRIE AVE SUITE 320
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City | INGLEWOOD
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State | CA
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Zip | 90301-4502
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Country | US
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Telephone | 310-671-8065
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Fax | 310-671-5810
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Provider Business Mailing Address
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Address Line | PO BOX 1274
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City | CULVER CITY
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State | CA
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Zip | 90232-1274
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Country | US
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Telephone | 310-671-8065
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Fax | 310-671-5810
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | E3561
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License Number State | CA
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