MARK S. WALLEN, D.P.M., INC.
Medical Practice in Santa Monica, CA

License number
California E 3104
Category
Medical Practice
Type
Foot Surgery
Owner
Name: DR. MARK S. WALLEN DPM
Title: OWNER
Phone: (310) 828-0122
Address
Address
2001 Santa Monica Blvd 1190 W, Santa Monica, CA 90404
National Provider ID: 1629009055
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about MARK S. WALLEN, D.P.M., INC. at bizstanding.com

MARK S. WALLEN, DPM, INC

Santa Monica, CA

Registration:
Jan 1, 2001
Addresses:
1260 15 St STE 1014, Santa Monica, CA 90404 (Physical)
2001 Santa Monica Blvd, Santa Monica, CA 90404
State ID:
C2242151
Business type:
Articles of Incorporation
Presidents:
Mark S Wallen (President),Mark S. Wallem President, inactive
Agent:
Gordon T Gassner,Encino, CA 91316 (Physical)

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