Healthcare Provider Details
I. General information
NPI: 1033429519
Provider Name (Legal Business Name): ERIC M FEIT DPM INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2010
Last Update Date: 04/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1360 WEST 6TH ST. SUITE 240
SAN PEDRO CA
90732
US
IV. Provider business mailing address
3655 LOMITA BLVD. SUITE 120
TORRANCE CA
90505
US
V. Phone/Fax
- Phone: 310-548-3311
- Fax: 310-548-3384
- Phone: 310-548-3311
- Fax: 310-548-3384
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | E3982 |
| License Number State | NY |
VIII. Authorized Official
Name:
ERIC
M
FEIT
Title or Position: PRESIDENT, OWNER
Credential: DPM
Phone: 310-548-3311