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General NPI Number Information
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NPI Number | 1942371224
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Entity Type | Organization
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Legal Business Name | MY FOOT CLINIC, INC.
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18022 PIONEER BLVD
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City | ARTESIA
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State | CA
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Zip | 90701-3905
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Country | US
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Telephone | 562-402-3668
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Fax | 562-402-7684
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Provider Business Mailing Address
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Address Line | 18022 PIONEER BLVD
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City | ARTESIA
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State | CA
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Zip | 90701-3905
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Country | US
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Telephone | 562-402-3668
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Fax | 562-402-7684
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHAWN S RABBANI
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Credential | DPM
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Telephone | 562-402-3668
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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 | E3914
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License Number State | CA
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