MEDICARE: DR. JOEL J. LIPKIN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	E2802	CA
2	213ES0103X	Foot & Ankle Surgery Podiatrist	E4839	CA

General Provider Information

NPI Number	:	1407856354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL J. LIPKIN DPM

Provider Business Mailing Address
First Line	:	32565-B GOLDEN LANTERN STREET #142
Second Line	:
City	:	DANA POINT
State	:	CA
Zip	:	92629-3261
Country	:	US
Telephone Number	:	714-878-2002
Fax Number	:

Provider Business Practice Location Address
First Line	:	5907 LANKERSHIM BLVD
Second Line	:
City	:	N HOLLYWOOD
State	:	CA
Zip	:	91601-1006
Country	:	US
Telephone Number	:	818-980-3073
Fax Number	:	877-340-3470

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	07/28/2016

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