MEDICARE: DR. DANIEL L ALTCHULER D P M

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	E01822A	CA

General Provider Information

NPI Number	:	1518071745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL L ALTCHULER D P M

Provider Business Mailing Address
First Line	:	1260 15TH ST STE 707
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-1142
Country	:	US
Telephone Number	:	310-451-8045
Fax Number	:	310-451-8139

Provider Business Practice Location Address
First Line	:	1260 15TH ST
Second Line	:	SUITE 707
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-1145
Country	:	US
Telephone Number	:	310-451-8045
Fax Number	:	310-451-8139

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	11/16/2023

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