Mark Costopoulos DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E2607 Issued in CA

Legal business name

MARK COSTOPOULOS DPM

Practice address

6333 Wilshire Blvd
Suite 304
Los Angeles, CA 90048-5702

Phone

(310) 376-3668

Fax

(310) 376-8777

NPI assigned

Jan 16, 2008

Organization subpart

No

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

Authorized official

Name

Mark Costopoulos, DPM

Title

Owner/Podiatrist

Phone

(310) 376-3668

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Farshid Nejad, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Beverly Hills, CA
  • NPI 1215936059
  NPD (past)

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1548446883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 WILSHIRE BLVD",
            "address_2": "SUITE 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485702",
            "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": "6333 WILSHIRE BLVD",
            "address_2": "SUITE 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485702",
            "telephone_number": "310-376-3668",
            "fax_number": "310-376-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK COSTOPOULOS DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "COSTOPOULOS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/PODIATRIST",
        "authorized_official_telephone_number": "310-376-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "4800033100",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LICENSE",
            "identifier": "E2607B",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E26071",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marjan Mohammadi D.D.S. Inc.
• Marjan Mohammadi DDS Inc
• Ani Marjanian
• Mark a Moses DDS Inc
• Mark B Lieberman DDS Inc
• Mark Davidson MD Inc
• Mark Fairfield, LCSW, BCD, a Licensed Clinical Social Work Corporation
• Mark H. Hyman M.D, Inc
• Mark J. Spoonamore M.D., Inc.
• Mark K. Sakakura, DDS., a Professional Corporation

• Podiatrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.