Mark S. Wallen, D.P.M., Inc.

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

E 3104 Issued in CA

Legal business name

MARK S. WALLEN, D.P.M., INC.

Practice address

2001 Santa Monica Blvd
1190 W
Santa Monica, CA 90404-2102

Phone

(310) 828-0122

Fax

(310) 828-4463

NPI assigned

Jul 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark S. Wallen, DPM

Title

Owner

Phone

(310) 828-0122

Specialties & licenses 1

Addresses

Practitioners 1

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

• Terry Jay Boykoff, DPM

  • Foot & Ankle Surgery Podiatrist
  • Santa Monica, CA
  • NPI 1497763072
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258070400000",
    "number": "1629009055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "1190 W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042102",
            "telephone_number": "310-828-0122",
            "fax_number": "310-828-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "1190 W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042102",
            "telephone_number": "310-828-0122",
            "fax_number": "310-828-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK S. WALLEN, D.P.M., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2009-11-13",
        "status": "A",
        "authorized_official_last_name": "WALLEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-828-0122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E 3104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mark Nachman MD a Proffesional Corporation
• Mark S Weintraub
• Mark Youssef a Medical Corporation
• Terry Marks-Tarlow, PH.D.
• Elisa Marks, OTR
• Marksherm, Inc
• William David Marley, EMT

• Foot Surgery Podiatrist in Santa Monica, CA
• Providers in Santa Monica, 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 Nov 13, 2009; 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.