# JOHN L ETCHEVERRY DPM INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548588270
- **Authorized official:** JOHN L ETCHEVERRY M.D. (PRESIDENT/OWNER)
- **Authorized official phone:** (818) 901-6600

## Contact information

- **Practice address:** 2400 BAHAMAS DR, 200, BAKERSFIELD, CA 93309-0745
- **Practice address phone:** (661) 328-5565
- **Practice address fax:** (818) 997-7826
- **Mailing address:** 6815 NOBLE AVE, VAN NUYS, CA 91405-3796
- **Mailing address phone:** (818) 901-6600
- **Mailing address fax:** (818) 997-7826

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | E4099 | CA | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | E4099 | CA | Yes |

## Other

- **Enumeration date:** 05/05/2010
- **Last updated:** 06/13/2011