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Organization
WEST BEVERLY PODIATRY GROUP, INC
Active
Organization
WEST BEVERLY PODIATRY GROUP, INC
Active
Other names
Arcadia West Beverly Podiatry Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE VEGA (MANAGER)
(323) 721-6026
Entity
Organization
Contact information
Practice address
638 W DUARTE RD STE 7, ARCADIA, CA 91007-9201
(626) 447-5122
(626) 447-5272
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
01
—
480003204
RAILROAD MEDICARE
CA
01
—
DA3847
RAILROAD
CA
05
—
GRE000310
—
CA
Enumeration date
07/31/2006
Last updated
07/23/2012
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