Individual provider Active NPI

Marc G Mittleman, D.P.M.

  • Podiatrist
  • Torrance, CA
National Provider Identifier
1700966587
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E2620 Issued in CA
Practice address
21250 Hawthorne Blvd
Suite 160
Torrance, CA 90503-5506
Phone
(310) 540-1213
Fax
(310) 540-7405
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E2620 CA Primary

Addresses

Primary practice location

21250 Hawthorne Blvd
Suite 160
Torrance, CA 90503-5506

Mailing address

21250 Hawthorne Blvd
Suite 160
Torrance, CA 90503-5506
Phone (310) 540-1213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E2620CAMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1700966587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21250 HAWTHORNE BLVD",
            "address_2": "SUITE 160",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035506",
            "telephone_number": "310-540-1213",
            "fax_number": "310-540-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21250 HAWTHORNE BLVD",
            "address_2": "SUITE 160",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035506",
            "telephone_number": "310-540-1213",
            "fax_number": "310-540-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTLEMAN",
        "first_name": "MARC",
        "middle_name": "G",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.