Provider Demographics
NPI:1275583700
Name:ALONGI, MARTIN P
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:P
Last Name:ALONGI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:HILLS
Other - Last Name:PODIATRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:416 N BEDFORD DR
Mailing Address - Street 2:STE #210
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4322
Mailing Address - Country:US
Mailing Address - Phone:310-274-5483
Mailing Address - Fax:310-274-4573
Practice Address - Street 1:416 N BEDFORD DR
Practice Address - Street 2:STE #210
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4322
Practice Address - Country:US
Practice Address - Phone:310-274-5483
Practice Address - Fax:310-274-4573
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE-3705213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWE3705AMedicare PIN