Organization · Type 2 NPI
Mark S. Wallen, D.p.m., Inc.
Foot Surgery Podiatrist · Santa Monica, CA
NPI number
1629009055
Active
Practice location
2001 Santa Monica Blvd, 1190 W
Santa Monica, CA 90404-2102
Fax (310) 828-4463
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot Surgery Podiatrist Primary | 213ES0131X | E 3104 (CA) |
Foot Surgery Podiatrist: Definition to come...
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About NPI 1629009055
Mark S. Wallen, D.p.m., Inc.'s National Provider Identifier is 1629009055, issued on Jul 5, 2006. The primary taxonomy on file is Foot Surgery Podiatrist (213ES0131X), and the practice location is in Santa Monica, CA. The record was last updated on Nov 13, 2009.