FAR WEST PODIATRIC MEDICAL GROUP NPI 1124175740

NPI Information

NPI: 1124175740
Provider Name: FAR WEST PODIATRIC MEDICAL GROUP

Doing Business As: FAR WEST PODIATRY

Classification: Podiatrist - 213ES0131X
Entity Type: Organization

Specialization: Foot Surgery

Address:
13624 HAWTHORNE BLVD STE 206
HAWTHORNE, CA
ZIP 90250
Phone: (310) 675-0900
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FAR WEST PODIATRIC MEDICAL GROUP is a foot surgery podiatrist in Hawthorne, CA. FAR WEST PODIATRIC MEDICAL GROUP NPI is 1124175740. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Far West Podiatry.

The provider's business location address is:

13624 HAWTHORNE BLVD STE 206
HAWTHORNE, CA
ZIP 90250-818
Phone: (310) 675-0900
Fax: (310) 675-0904

The provider's authorized official is Karen L Wrubel .
The authorized official title is President and has the following contact phone number (310) 675-0900.

The enumeration date for this NPI number is 1/4/2007 and was last updated on 7/13/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0131X	Podiatrist	Foot Surgery	E3328	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GRE001780	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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