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General NPI Number Information
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NPI Number | 1215376348
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Entity Type | Individual
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Provider Name | MICHAEL JAMES CORPUZ D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 200 N ROBERTSON BLVD STE 202
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-6002
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Country | US
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Telephone | 310-423-3078
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Fax |
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Provider Business Mailing Address
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Address Line | 4115 CENTRALIA ST
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City | LAKEWOOD
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State | CA
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Zip | 90712-3851
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Country | US
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Telephone | 562-857-7823
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | EL1951
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E5261
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License Number State | CA
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