Active NPI
Russell J Wojcik, D.P.M.
- Podiatrist
- Los Angeles, CA
National Provider Identifier
1083760995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E1920
- Practice address
- 419 1/2 N Larchmont Blvd
Los Angeles, CA 90004-3013 - Phone
- (213) 385-1266
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E1920 | CA | Primary |
Addresses
Primary practice location
419 1/2 N Larchmont Blvd
Los Angeles, CA 90004-3013
Mailing address
12807 Elkwood St
North Hollywood, CA 91605-2035
Phone (213) 385-1266
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000E19200 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E1920 | CA | MD | Podiatrist |
| 1920 | CA | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229040000000",
"number": "1083760995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12807 ELKWOOD ST",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916052035",
"telephone_number": "213-385-1266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 1/2 N LARCHMONT BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900043013",
"telephone_number": "213-385-1266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOJCIK",
"first_name": "RUSSELL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2008-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CA",
"license": "E1920",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000E19200",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.