Eric J. Klostermann, D.P.M., a Professional Corporation

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

E1993 Issued in CA

Legal business name

ERIC J. KLOSTERMANN, D.P.M., A PROFESSIONAL CORPORATION

Practice address

4560 Admiralty Way
Suite 351
Marina del Rey, CA 90292-5423

Phone

(310) 792-3914

Fax

(855) 898-4055

NPI assigned

Sep 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Eric J Klostermann, D.P.M.

Title

President

Phone

(310) 792-3914

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1154518801",
    "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": "902925423",
            "telephone_number": "310-792-3914",
            "fax_number": "855-898-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC J. KLOSTERMANN, D.P.M., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "KLOSTERMANN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-792-3914",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "CA",
            "license": "E1993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000E19930",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E19931",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatric Clinic/Center in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Podiatric Clinic/Center 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.