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General NPI Number Information
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NPI Number | 1801125018
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Entity Type | Organization
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Legal Business Name | PODIATRY SERVICES
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Dates
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Enumeration Date | 12/17/2009
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Last Update Date | 06/24/2019
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Provider Practice Location Address
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Address Line | 24640 JEFFERSON AVE STE 109
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City | MURRIETA
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State | CA
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Zip | 92562-9027
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Country | US
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Telephone | 951-677-1323
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Fax |
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Provider Business Mailing Address
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Address Line | 24640 JEFFERSON AVE STE 109
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City | MURRIETA
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State | CA
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Zip | 92562-9027
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Country | US
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Telephone | 951-677-1323
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH S WELLS
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Credential | DPM
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Telephone | 951-677-1323
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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 | E2077
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License Number State | CA
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