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General NPI Number Information
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NPI Number | 1326462110
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Entity Type | Organization
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Legal Business Name | BEVERLY HILLS PODIATRY, INC
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Dates
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Enumeration Date | 02/13/2014
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Last Update Date | 02/13/2014
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Provider Practice Location Address
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Address Line | 416 N BEDFORD DR STE 307
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4309
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Country | US
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Telephone | 310-274-5483
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Fax | 310-274-4573
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Provider Business Mailing Address
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Address Line | 416 N BEDFORD DR STE 307
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4309
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Country | US
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Telephone | 310-274-5483
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Fax | 310-274-4573
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Authorized Official
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Title or Position | MANAGER
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Name | MARY ALONGI
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Credential |
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Telephone | 310-274-5483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E-3705
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License Number State | CA
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