Provider Demographics
NPI:1053079848
Name:LOS FELIZ FOOT AND ANKLE
Entity Type:Organization
Organization Name:LOS FELIZ FOOT AND ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RILLING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:323-666-5585
Mailing Address - Street 1:1909 HILLHURST AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-2711
Mailing Address - Country:US
Mailing Address - Phone:323-666-5585
Mailing Address - Fax:323-666-9784
Practice Address - Street 1:1909 HILLHURST AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-2711
Practice Address - Country:US
Practice Address - Phone:323-666-5585
Practice Address - Fax:323-666-9784
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOS FELIZ FOOT AND ANKLE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies