MEDICARE: EUCLID FOOT CLINIC 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	E3270	CA

General Provider Information

NPI Number	:	1346339330
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EUCLID FOOT CLINIC PODIATRY GROUP, INC.

Provider Business Mailing Address
First Line	:	PO BOX 8877
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92728-8877
Country	:	US
Telephone Number	:	714-850-1300
Fax Number	:	714-850-1301

Provider Business Practice Location Address
First Line	:	2621 S BRISTOL ST STE 209
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-5719
Country	:	US
Telephone Number	:	714-850-1300
Fax Number	:	714-850-1301

Authorized Official
Title or Position	:	OWNER
Name	:	PAUL Y. HAN
Credential	:	DPM
Telephone Number	:	714-850-1300

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	11/20/2024

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