MEDICARE: CURE4FEET PODIATRY GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	E4721	CA
2	213ES0103X	Foot & Ankle Surgery Podiatrist	E4237	CA
3	213ES0103X	Foot & Ankle Surgery Podiatrist	E5130	CA
4	213ES0103X	Foot & Ankle Surgery Podiatrist	1927	CA
5	213ES0103X	Foot & Ankle Surgery Podiatrist	E4839	CA

General Provider Information

NPI Number	:	1104149269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CURE4FEET PODIATRY GROUP INC

Provider Business Mailing Address
First Line	:	5907 LANKERSHIM BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-1006
Country	:	US
Telephone Number	:	818-980-3073
Fax Number	:	866-818-0816

Provider Business Practice Location Address
First Line	:	5907 LANKERSHIM BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-1006
Country	:	US
Telephone Number	:	818-980-3073
Fax Number	:	866-818-0816

Authorized Official
Title or Position	:	PRESIDENT/DPM
Name	:	DR. KHANH T DUONG
Credential	:	DPM
Telephone Number	:	714-697-9939

Provider Enumeration Date	:	03/03/2010
Last Update Date	:	07/07/2015

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