Provider Demographics
NPI:1740575331
Name:GOLDEN ARCHES PODIATRY, INC.
Entity Type:Organization
Organization Name:GOLDEN ARCHES PODIATRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIRAN
Authorized Official - Middle Name:NAGARAJA
Authorized Official - Last Name:SETTY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:909-567-9301
Mailing Address - Street 1:10220 FOOTHILL BLVD
Mailing Address - Street 2:4302
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0343
Mailing Address - Country:US
Mailing Address - Phone:909-567-9301
Mailing Address - Fax:
Practice Address - Street 1:1000 W BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4139
Practice Address - Country:US
Practice Address - Phone:909-567-9301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-13
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4739213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty