Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Southern California Foot and Ankle Medical Center

Organization Foot & Ankle Surgery Podiatrist · NPI 1134650500

Southern California Foot and Ankle Medical Center provides Foot & Ankle Surgery Podiatrist services in Los Angeles, California. Licensed in California. Registered with an NPI since 2017.

Licensed in
CA
In the registry since
2017

Practice location Address checks out

520 S Virgil Ave Ste 105
Los Angeles, CA 90020-1416
Phone: (213) 352-1090
Fax: (562) 249-8443
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence E5105 (CA)

Record details

NPI number1134650500
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sang Kim — Secretary · (562) 606-4519
NPI enumeratedMarch 27, 2017
Last updated in NPPESDecember 20, 2022
Certification dateDecember 20, 2022
Mailing address520 S Virgil Ave, Suite 105, Los Angeles, CA 90020-1416

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