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General NPI Number Information
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NPI Number | 1740575331
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Entity Type | Organization
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Legal Business Name | GOLDEN ARCHES PODIATRY, INC.
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 02/11/2020
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Provider Practice Location Address
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Address Line | 1000 W BEVERLY BLVD
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City | MONTEBELLO
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State | CA
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Zip | 90640-4139
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Country | US
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Telephone | 909-567-9301
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Fax |
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Provider Business Mailing Address
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Address Line | 10220 FOOTHILL BLVD 4302
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0343
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Country | US
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Telephone | 909-567-9301
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KIRAN NAGARAJA SETTY
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Credential | D.P.M
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Telephone | 909-567-9301
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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 | E4739
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License Number State | CA
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