Makovic, Gregg Robert
Makovic, Gregg Robert is an sole proprietor health care provider with primary practice located at 717 S Averill Ave , San Pedro CA 90732-3813. He recently has 3 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Makovic, Gregg Robert can be contacted via phone (310) 548-6298.Contact Information
Primary practice address
717 S Averill Ave
San Pedro CA 90732-3813
Phone: (310) 548-6298
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | E2521 | California |
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine | 213EP1101X | E2521 | California |
Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | E2521 | California |
Profile Details
NPI number | 1598836769 |
---|---|
LBN Legal business name | Makovic, Gregg Robert |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 10th, 2006 |
Last updated | Mar 27th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1598836769 | NPPES |
California | MEDICAID | 000E25210 |
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