Mark Costopoulos DPM

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

E2607 Issued in CA

Legal business name

MARK COSTOPOULOS DPM

Practice address

608 N Sepulveda Blvd
Manhattan Beach, CA 90266-5921

Phone

(310) 376-3668

Fax

(310) 376-8777

NPI assigned

Mar 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mark Costopoulos, D.P.M.

Title

Owner

Phone

(310) 376-3668

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1235300310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 N SEPULVEDA BLVD",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665921",
            "telephone_number": "310-376-3668",
            "fax_number": "310-376-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 N SEPULVEDA BLVD",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665921",
            "telephone_number": "310-376-3668",
            "fax_number": "310-376-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK COSTOPOULOS DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "COSTOPOULOS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-376-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E2607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E26070",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LICENSE #",
            "identifier": "E2607A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brithany Marbun
• Jeffrey Marchesani
• Marcia a. Matika DPM, Inc.
• Dianne Marin
• Marina Pharmacy Inc. (dba Hillside Pharmacy)
• Michael Mark
• Kimberly Crystal Markley, AMFT, CTP, LMFT
• Nikole Markow
• Susmitha Marneni, DDS
• Octavio Marquez Montoya, ATC

• Foot Surgery Podiatrist in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Foot Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.

Verify at the official NPI Registry.