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General NPI Number Information
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NPI Number | 1811280548
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Entity Type | Organization
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Legal Business Name | KIBROM G ASRAT DPM APC
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Dates
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Enumeration Date | 05/27/2011
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 13132 STUDEBAKER RD STE 1
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City | NORWALK
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State | CA
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Zip | 90650-2558
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Country | US
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Telephone | 562-868-0700
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Fax | 562-888-6023
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Provider Business Mailing Address
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Address Line | PO BOX 321
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City | NORWALK
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State | CA
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Zip | 90651-0321
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Country | US
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Telephone | 562-868-0700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KIBROM GHIRMAY ASRAT
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Credential | D.P.M
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Telephone | 562-868-0700
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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 | E4925
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License Number State | CA
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