Provider Demographics
NPI:1306975230
Name:DOWNEY PODIATRY CENTER, INC.
Entity type:Organization
Organization Name:DOWNEY PODIATRY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOEUNG
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHOV
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:626-497-3300
Mailing Address - Street 1:PO BOX 40494
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90239-1494
Mailing Address - Country:US
Mailing Address - Phone:626-497-3300
Mailing Address - Fax:
Practice Address - Street 1:11003 LAKEWOOD BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3809
Practice Address - Country:US
Practice Address - Phone:562-869-3668
Practice Address - Fax:562-869-8409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABW222AMedicare PIN
CAW21828Medicare PIN
CA6084070001Medicare NSC