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Organization
WEST BEVERLY PODIATRY GROUP, INC.
Active
Organization
WEST BEVERLY PODIATRY GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE LOUISE VEGA (MANAGER)
(323) 721-6026
Entity
Organization
Contact information
Practice address
1417 W BEVERLY BLVD, 104, MONTEBELLO, CA 90640-4123
(323) 721-6026
(323) 887-1891
Mailing address
1417 W BEVERLY BLVD, 104, MONTEBELLO, CA 90640-4123
(323) 721-6026
(323) 887-1891
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1101320
—
CA
01
—
480009960
RAILROAD
CA
01
—
DA3847
RAILROAD
CA
05
—
GRE000311
—
CA
Enumeration date
07/31/2006
Last updated
08/02/2022
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