IndividualActive
Allen Degrandmont, DPM
NPI 1962450833 · Foot & Ankle Surgery Podiatrist · Costa Mesa, CA
Provider details
- NPI number
- 1962450833
- Entity type
- Individual
- Primary specialty
- Foot & Ankle Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- Yes
- License
- E1767 (CA)
Practice location
188 E 17th St
Suite #101
Costa Mesa, CA 92627-3763
Phone: (949) 646-7110
Fax: (949) 646-3957
Mailing address
188 E 17th St
Costa Mesa, CA 92627-3763
Registry dates
- Enumerated
- 2006-05-04
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.