institution
Mark S. Wallen, D.p.m., Inc.
Foot Surgery Podiatrist in Santa Monica, California
NPI 1629009055

Mark S. Wallen, D.p.m., Inc. is a Foot Surgery Podiatrist based in Santa Monica, CA and is specialized in Foot Surgery. Mark S. Wallen, D.p.m., Inc. practices in Santa Monica, CA. The NPI Number for Mark S. Wallen, D.p.m., Inc. is 1629009055 and holds a License No. E 3104 (California).

The current practice location address for Mark S. Wallen, D.p.m., Inc. is 2001 Santa Monica Blvd, Santa Monica, CA and can be reached out via phone at 310-828-0122 and via fax at 310-828-4463.

Location: 2001 Santa Monica Blvd, Santa Monica, CA, 90404-2102
institution
Provider Profile Details
NPI Number
1629009055
Provider Name
Mark S. Wallen, D.p.m., Inc.
Credential
Provider Entity Type
Organization
Address
2001 Santa Monica Blvd, Santa Monica, CA, 90404-2102
Phone Number
310-828-0122
Fax Number
310-828-4463
Provider Enumeration Date
07/05/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
2001 Santa Monica Blvd
City
State
Zip
90404-2102
Phone Number
310-828-0122
Fax Number
310-828-4463
person
Provider Business Mailing Address Details
Address
2001 Santa Monica Blvd
City
State
Zip
90404-2102
Phone Number
310-828-0122
Fax Number
310-828-4463
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot Surgery
Taxonomy
License No.
E 3104 (California)
Definition
Definition to come...
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