Organization
HARBOR FOOT AND ANKLE PODIATRIC MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE D LEVINE DPM (PRESIDENT)
(310) 548-1191
Entity
Organization
Contact information
Practice address
1360 W 6TH ST, SUITE 150W, SAN PEDRO, CA 90732-3514
(310) 548-1191
Mailing address
1360 W 6TH ST, SUITE 150W, SAN PEDRO, CA 90732-3514
(310) 548-1191
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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