Organization Name: | MIKE C JOU DPM INC |
NPI Number: | 1427133040 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MIKE C JOU (CEO) |
Mailing Address: | 1661 Hanover Rd Suite 104 City Of Industry |
State: | CA US |
Postal Code: | 917481796 |
Phone Number: | 6268200924 |
Fax Number: | 6268200925 |
NPI Enumeration Date: | 10/25/2006 |
NPI Last Update Date: | 04/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP1100X |
License Number: | E4187 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Podiatric |
Taxonomy Definition: |