Organization
ERIC J. KLOSTERMANN, D.P.M., A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC J KLOSTERMANN D.P.M. (PRESIDENT)
(310) 792-3914
Entity
Organization
Contact information
Practice address
4560 ADMIRALTY WAY, SUITE 351, MARINA DEL REY, CA 90292-5423
(310) 792-3914
(855) 898-4055
Mailing address
PO BOX 3129, TORRANCE, CA 90510-3129
(310) 792-3914
(855) 898-4055
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
E1993
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000E19930
BLUE SHIELD
CA
05
—
000E19931
—
CA
Enumeration date
09/26/2007
Last updated
10/21/2016
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