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General NPI Number Information
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NPI Number | 1902246366
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Entity Type | Organization
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Legal Business Name | DIABETIC FOOT SURGEONS OF CALIFORNIA INC
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 05/24/2018
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Provider Practice Location Address
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Address Line | 3330 LOMITA BLVD WEST TOWER 5TH FLOOR
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City | TORRANCE
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State | CA
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Zip | 90505
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Country | US
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Telephone | 310-517-4736
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 S PACIFIC COAST HWY UNIT 28
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City | REDONDO BEACH
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State | CA
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Zip | 90277-6161
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Country | US
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Telephone | 310-517-4736
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Fax | 310-784-8763
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAREN SHUM
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Credential | DPM
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Telephone | 310-517-4736
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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 |
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License Number State |
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