MEDICARE: THOMAS F. CLEMENTE, DPM INC & JOHN D. HALEBIAN, DPM PTRS

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	213ES0131X	Foot Surgery Podiatrist	E2819	CA
2	213ES0131X	Foot Surgery Podiatrist	E2604	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1023091808	OTHER	CA	INDIVIDUAL NPI NUMBER/ JOHN D. HALEBIAN, DPM
2	1497755110	OTHER	CA	INDIVIDUAL NPI NUMBER/THOMAS F. CLEMENTE, DPM

General Provider Information

NPI Number	:	1891809554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS F. CLEMENTE, DPM INC & JOHN D. HALEBIAN, DPM PTRS

Provider Business Mailing Address
First Line	:	23929 MCBEAN PKWY
Second Line	:	SUITE 212
City	:	VALENCIA
State	:	CA
Zip	:	91355-4466
Country	:	US
Telephone Number	:	661-290-2857
Fax Number	:	661-290-2880

Provider Business Practice Location Address
First Line	:	23929 MCBEAN PKWY STE 212
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-4468
Country	:	US
Telephone Number	:	661-290-2857
Fax Number	:	661-290-2880

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. JULIE MARIE GORDON-BARRETTO
Credential	:
Telephone Number	:	661-290-2857

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	05/18/2015

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