Southern California Podiatry Group, Inc.

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

SOUTHERN CALIFORNIA PODIATRY GROUP, INC.

Doing business as

DSP

Practice address

2661 E Florence Ave
Suite B
Huntington Park, CA 90255-4793

Phone

(323) 583-4440

Fax

(323) 583-4499

NPI assigned

Oct 9, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jason Wach

Title

Treasurer/Secretary

Phone

(562) 896-5899

Specialties & licenses 1

Addresses

Other names 1

• DSP Doing business as

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699862755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6030 VALENCIA ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928803088",
            "telephone_number": "562-896-5899",
            "fax_number": "562-236-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2661 E FLORENCE AVE",
            "address_2": "SUITE B",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554793",
            "telephone_number": "323-583-4440",
            "fax_number": "323-583-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA PODIATRY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WACH",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "TREASURER/SECRETARY",
        "authorized_official_telephone_number": "562-896-5899",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DSP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Atlantic Medical Group
• South Central Family Health Center (SCFHC - Santa Fe)
• South Central Family Health Center (SCFHC Florence Health Center)
• South Central Family Health Center (Huntington Park Family Health Center)
• South Coast Surgery Center Inc (South Coast Surgery Center)
• Southern California Surgery Center, Inc
• Southwestern Anesthesia Group (Swag)
• Damani Spearman
• Roxanne Spencer
• Lodie Nanette Spurlock, PA-C

• Podiatrist in Huntington Park, CA
• Providers in Huntington Park, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.