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NPI 1891708657

NPI 1891708657 : MICHAEL VARSHO DPM : SOUTH GATE, CA

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General NPI Number Information
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    NPI Number           |    1891708657
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    Entity Type          |    Individual 
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    Provider Name        |    MICHAEL VARSHO DPM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/14/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    3425 FIRESTONE BLVD 
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    City                 |    SOUTH GATE
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    State                |    CA
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    Zip                  |    90280
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    Country              |    US
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    Telephone            |    323-566-1183
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4311 COLFAX AVE 105
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    City                 |    STUDIO CITY
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    State                |    CA
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    Zip                  |    91604
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    Country              |    US
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    Telephone            |    818-766-1784
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    Fax                  |    
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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        |    213E00000X
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    Taxonomy Name        |    Podiatrist
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    License Number       |    E3230
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    License Number State |    CA
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