Organization · Type 2 NPI

Michaelbastanidpm

Foot & Ankle Surgery Podiatrist · Irvine, CA

NPI number 1407496318 Active

Practice location

22 Odyssey Ste 115
Irvine, CA 92618-3188

Call (424) 256-8956 Map

Mailing address

23785 El Toro Rd # 450
Lake Forest, CA 92630-4762

Specialties and licenses

TaxonomyCodeLicense
Foot & Ankle Surgery Podiatrist Primary 213ES0103XNone listed

Foot & Ankle Surgery Podiatrist: Definition to come...

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About NPI 1407496318

Michaelbastanidpm's National Provider Identifier is 1407496318, issued on Jan 8, 2020. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Irvine, CA. The record was last updated on Jan 8, 2020.