Eric J Klostermann, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E-1993 Issued in CA

Practice address

4560 Admiralty Way
Suite 351
Marina del Rey, CA 90292-5426

Phone

(310) 792-3914

Fax

(855) 898-4055

NPI assigned

Jun 24, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1104852797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3129",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905103129",
            "telephone_number": "310-792-3914",
            "fax_number": "855-898-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY",
            "address_2": "SUITE 351",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925426",
            "telephone_number": "310-792-3914",
            "fax_number": "855-898-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOSTERMANN",
        "first_name": "ERIC",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E-1993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E19931",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000E19930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.