# HARBOR FOOT AND ANKLE PODIATRIC MEDICAL GROUP

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

## Provider details

- **NPI number:** 1760832851
- **Authorized official:** BRUCE D LEVINE DPM (PRESIDENT)
- **Authorized official phone:** (310) 548-1191

## Contact information

- **Practice address:** 1360 W 6TH ST, SUITE 150W, SAN PEDRO, CA 90732-3514
- **Practice address phone:** (310) 548-1191
- **Mailing address:** 1360 W 6TH ST, SUITE 150W, SAN PEDRO, CA 90732-3514
- **Mailing address phone:** (310) 548-1191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 06/20/2016
- **Last updated:** 06/20/2016