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NPI Code Detail

MEDICARE: DR. BARRY A. WERTHEIMER D.P.M.

MEDICARE: DR. BARRY A. WERTHEIMER 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
1213E00000XPodiatristE-1248CA

General Provider Information

NPI Number : 1861413379
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BARRY A. WERTHEIMER D.P.M.
Provider Business Mailing Address
First Line : 2850 ARTESIA BLVD
Second Line : SUITE 204
City : REDONDO BEACH
State : CA
Zip : 90278-3419
Country : US
Telephone Number : 310-530-0544
Fax Number : 310-541-0168
Provider Business Practice Location Address
First Line : 2850 ARTESIA BLVD
Second Line : SUITE 204
City : REDONDO BEACH
State : CA
Zip : 90278-3419
Country : US
Telephone Number : 310-530-0544
Fax Number : 310-541-0168
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 02/26/2008

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