Provider Demographics
NPI:1073617478
Name:OSWELL, NOREEN NOELLE (DPM)
Entity Type:Individual
Prefix:DR
First Name:NOREEN
Middle Name:NOELLE
Last Name:OSWELL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8631 W 3RD ST STE 303E
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5907
Mailing Address - Country:US
Mailing Address - Phone:310-360-0001
Mailing Address - Fax:310-360-0135
Practice Address - Street 1:8631 W 3RD ST STE 303E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5907
Practice Address - Country:US
Practice Address - Phone:310-360-0001
Practice Address - Fax:310-360-0135
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3441213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1034830001Medicare NSC
CAE3441Medicare ID - Type Unspecified
CAT96131Medicare UPIN