Healthcare Provider Details
I. General information
NPI: 1831808062
Provider Name (Legal Business Name): ESPIR MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/16/2022
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14555 HAMLIN ST STE 2
VAN NUYS CA
91411-1612
US
IV. Provider business mailing address
14555 HAMLIN ST STE 2
VAN NUYS CA
91411-1612
US
V. Phone/Fax
- Phone: 323-606-9032
- Fax: 323-606-9036
- Phone: 323-606-9032
- Fax: 323-606-9036
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALBEMAR
ESPIRITU
Title or Position: PRESIDENT
Credential: DPM
Phone: 323-606-9032