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General NPI Number Information
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NPI Number | 1659407120
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Entity Type | Organization
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Legal Business Name | VALLEY FOOT SURGEONS, A PODIATRY GROUP, INC.
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 18411 CLARK ST SUITE 107
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City | TARZANA
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State | CA
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Zip | 91356-3506
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Country | US
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Telephone | 818-342-1600
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Fax | 818-342-1609
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Provider Business Mailing Address
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Address Line | PO BOX 972
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City | WOODLAND HILLS
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State | CA
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Zip | 91365-0972
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Country | US
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Telephone | 818-342-1600
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Fax | 818-342-1609
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Authorized Official
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Title or Position | PRESIDENT, SECRETARY
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Name | DR. ROSE DIANE GILMAN KLINE
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Credential | D.P.M.
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Telephone | 818-342-1600
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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 | E2775
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License Number State | CA
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