Mark T Kidon DPM Facfas a Podiatry Corporation

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E3196 Issued in CA

Legal business name

MARK T KIDON DPM FACFAS A PODIATRY CORPORATION

Practice address

10 Congress St
Ste 410
Pasadena, CA 91105-3045

Phone

(626) 799-1194

Fax

(626) 449-9862

NPI assigned

May 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark T Kidon, DPM

Title

President

Phone

(626) 799-1194

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525737600000",
    "number": "1457567570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CONGRESS ST",
            "address_2": "STE 410",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053045",
            "telephone_number": "626-799-1194",
            "fax_number": "626-449-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CONGRESS ST",
            "address_2": "STE 410",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053045",
            "telephone_number": "626-799-1194",
            "fax_number": "626-449-9862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Congress St",
            "address_2": "Ste 410",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911053045",
            "country_code": "US",
            "telephone_number": "626-799-1194",
            "fax_number": "626-449-9862",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Congress St",
            "address_2": "Ste 410",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911053045",
            "country_code": "US",
            "telephone_number": "626-799-1194",
            "fax_number": "626-449-9862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARK T KIDON DPM FACFAS A PODIATRY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2018-05-08",
        "status": "A",
        "authorized_official_last_name": "KIDON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-799-1194",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E31960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.