Provider Demographics
NPI:1770678492
Name:LOS ALAMITOS FOOT CLINIC
Entity Type:Organization
Organization Name:LOS ALAMITOS FOOT CLINIC
Other - Org Name:JOSEPH M. HUGHES, DPM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:562-799-0992
Mailing Address - Street 1:10961 CHERRY STREET
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2452
Mailing Address - Country:US
Mailing Address - Phone:562-799-0992
Mailing Address - Fax:562-799-0298
Practice Address - Street 1:10961 CHERRY STREET
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2452
Practice Address - Country:US
Practice Address - Phone:562-799-0992
Practice Address - Fax:562-799-0298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3207213ES0103X
CAWE3207B213ES0103X
WE3642A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWE12222Medicare UPIN
0488190001Medicare NSC