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General NPI Number Information
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NPI Number | 1669658043
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Entity Type | Organization
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Legal Business Name | COMPLETE CARE PODIATRY GROUP
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Dates
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Enumeration Date | 01/15/2008
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Last Update Date | 01/15/2008
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Provider Practice Location Address
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Address Line | 13132 STUDEBAKER RD SUITE 2
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City | NORWALK
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State | CA
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Zip | 90650-2557
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Country | US
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Telephone | 562-651-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 311 N ROBERTSON BLVD #677
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1705
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JAMES T BEATY
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Credential | DPM
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Telephone | 805-646-7163
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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 | E4302
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License Number State | CA
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