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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