DR. MARK COSTOPOULOS (NPI# 1669477717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669477717 |
| Entity Type | Individual |
| Full Name | DR. MARK COSTOPOULOS |
| Credential | D.P.M. |
| Practice Address |
608 N Sepulveda Blvd Manhattan Beach CA 90266-5921 |
| Practice Telephone | 3103763668 |
| Practice Fax Number | 3103768777 |
| Mailing Telephone | 3103763668 |
| Mailing Fax Number | 3103768777 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2008-10-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | E2607 | CA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE LICENSE | E2607A | 01 |
| CA | 000E26070 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770555633 | Mark G Costopoulos | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2006-02-06 |
| Street Address |
608 N SEPULVEDA BLVD |
| City | MANHATTAN BEACH |
| State | CA |
| Zip Code | 90266-5921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235300310 | Mark Costopoulos Dpm | Podiatrist | 608 N Sepulveda Blvd, Manhattan Beach, CA 90266-5921 | 2008-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770099756 | Tene Anderson | Massage Therapist | 500 S. Sepulveda Blvd, 207, Manhattan Beach, CA 90266 | 2017-12-28 |
| 1689035552 | Sean Limahelu | Physical Therapist | 400 S. Sepulveda Blvd. Suite 105, Manhattan Beach, CA 90266 | 2016-03-18 |
| 1609248053 | Nora Lillian Fong | General Practice | 425 15th St., Manhattan Beach, CA 90266 | 2015-10-26 |
| 1598182461 | Behavior and Education Inc | Day Training, Developmentally Disabled Services | 1888 Rosecrans Ave, Suite 2200, Manhattan Beach, CA 90266 | 2014-03-27 |
| 1538502406 | Cynara Conroy Allison | Marriage & Family Therapist | 1716 Manhattan Beach Blvd. #c, Manhattan Beach, CA 90266 | 2013-04-10 |
| 1598001919 | Cassandra Giornali Sorrell | Marriage & Family Therapist | 1050 Duncan Avenue, Suite K, Manhattan Beach, CA 90266 | 2012-12-13 |
| 1669716056 | Maria Lynn Newson | Marriage & Family Therapist | 2007 Cedar Avenue, Manhattan Beach, CA 90266 | 2012-11-26 |
| 1407113376 | Mona-lisa Lind | Marriage & Family Therapist | 901 North Pacific Coast Hwy., Ste. 200a-204a, Redondo Beach, CA 90266 | 2012-04-17 |
| 1790063964 | Chad Chin Seng Heng | Anesthesiology | 400 S Sepulveda Blvd Ste 200, Manhattan Beach, CA 90266 | 2011-07-21 |
| 1417262908 | Jennifer V. Izzarelli | Nurse Practitioner | 111 North Sepulveda Boulevard, Suite 210, Manhattan Beach, CA 90266 | 2010-08-10 |
| Find all providers in zip 90266 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649884610 | South Bay Foot & Ankle Specialists, Inc. | Podiatrist | 5565 Grossmont Center Dr Ste 510, La Mesa, CA 91942-3024 | 2020-09-07 |
| 1811512866 | Ankle & Foot Care Center Inc | Podiatrist | 15141 Whittier Blvd Ste 330, Whittier, CA 90603-2168 | 2020-06-15 |
| 1912528928 | Clement Podiatry PC | Podiatrist | 505 Sansome St Ste 850, San Francisco, CA 94111-3114 | 2020-04-30 |
| 1942834775 | Felix Sigal Dpm A Professional Corporation | Podiatrist | 201 S Alvarado St Ste 819, Los Angeles, CA 90057-2391 | 2020-03-02 |
| 1033758339 | Yosemite Bone and Joint Inc | Podiatrist | 1199 Delbon Ave Ste 1, Turlock, CA 95382-2006 | 2020-01-03 |
| 1194361634 | K David Flora Dpm Inc | Podiatrist | 1086 N Cherry St, Tulare, CA 93274-2251 | 2019-11-19 |
| 1902457963 | Silverlake Virgil Surgery Center | Podiatrist | 3367 W 1st St Ste 204, Los Angeles, CA 90004-6080 | 2019-09-21 |
| 1134778178 | Mohamad Belal Sharif | Podiatrist | Va Loma Linda 11201 Benton St, Loma Linda, CA 92357-0001 | 2019-09-11 |
| 1972159366 | Bay Area Surgical Specialists Inc A Medical Corporation | Podiatrist | 6061 N 1st St Ste 103, Fresno, CA 93710-5470 | 2019-08-13 |
| 1790331189 | Bay Area Surgical Specialists Inc A Medical Corporation | Podiatrist | 774 N Prospect St Ste B, Porterville, CA 93257-1941 | 2019-08-13 |
| Find all providers with the same taxonomy | ||||
| City | MANHATTAN BEACH |
| Zip Code | 90266 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.