institution
Mark Costopoulos Dpm
Foot Surgery Podiatrist in Manhattan Beach, California
NPI 1235300310

Mark Costopoulos Dpm is a Foot Surgery Podiatrist based in Manhattan Beach, CA and is specialized in Foot Surgery. Mark Costopoulos Dpm practices in Manhattan Beach, CA. The NPI Number for Mark Costopoulos Dpm is 1235300310 and holds a License No. E2607 (California).

The current practice location address for Mark Costopoulos Dpm is 608 N Sepulveda Blvd, Manhattan Beach, CA and can be reached out via phone at 310-376-3668 and via fax at 310-376-8777.

Location: 608 N Sepulveda Blvd, Manhattan Beach, CA, 90266-5921
institution
Provider Profile Details
NPI Number
1235300310
Provider Name
Mark Costopoulos Dpm
Credential
Provider Entity Type
Organization
Address
608 N Sepulveda Blvd, Manhattan Beach, CA, 90266-5921
Phone Number
310-376-3668
Fax Number
310-376-8777
Provider Enumeration Date
03/18/2008
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
000E26070 05 CA
E2607A 01 CA MEDICARE LICENSE #
institution
Provider Business Practice Location Address Details
Address
608 N Sepulveda Blvd
City
State
Zip
90266-5921
Phone Number
310-376-3668
Fax Number
310-376-8777
person
Provider Business Mailing Address Details
Address
608 N Sepulveda Blvd
City
State
Zip
90266-5921
Phone Number
310-376-3668
Fax Number
310-376-8777
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot Surgery
Taxonomy
License No.
E2607 (California)
Definition
Definition to come...
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