| Russell A Grootegoed, DPM | |
|
601 W 9th St, San Pedro, CA 90731-3107 | |
| (310) 833-3583 | |
| (310) 833-1976 |
| Full Name | Russell A Grootegoed |
|---|---|
| Gender | Male |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 601 W 9th St, San Pedro, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194767921 | NPI | - | NPPES |
| 953239247 | Other | CA | BLUE CROSS |
| 000E2064000 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | E2064 (California) | Primary |
| 335E00000X | Prosthetic/orthotic Supplier | E2064 (California) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Russell A Grootegoed, DPM 601 W 9th St, San Pedro, CA 90731-3107 Ph: (310) 833-3583 | Russell A Grootegoed, DPM 601 W 9th St, San Pedro, CA 90731-3107 Ph: (310) 833-3583 |
San Miguel Urgent Care San Pedro Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 525 W 7th St, San Pedro, CA 90731 Phone: 424-264-5630 | |
Eric M Feit Dpm Inc Podiatrist Medicare: Medicare Enrolled Practice Location: 1360 West 6th St., Suite 240, San Pedro, CA 90732 Phone: 310-548-3311 Fax: 310-548-3384 | |
Barry Rodgveller Dpm Podiatry Corporation Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1360 W 6th St, Suite 240, San Pedro, CA 90732 Phone: 310-548-3311 Fax: 310-548-3384 | |
Tad Fennar, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 1300 W 6th St, Suite 2, San Pedro, CA 90732 Phone: 310-831-0728 Fax: 310-831-8564 | |
Eric M Feit, DPM, INC Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1360 W 6th St, 240, San Pedro, CA 90732 Phone: 310-548-3311 Fax: 310-548-3384 | |
Bruce D Levine, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1360 W 6th St, 150w, San Pedro, CA 90732 Phone: 310-548-1191 Fax: 310-548-4007 |