Provider Demographics
NPI:1538223169
Name:BYRON S ALBERTY DPM INC
Entity type:Organization
Organization Name:BYRON S ALBERTY DPM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ALBERTY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:562-789-0444
Mailing Address - Street 1:8751 E CLOUDVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-1658
Mailing Address - Country:US
Mailing Address - Phone:714-281-4466
Mailing Address - Fax:
Practice Address - Street 1:15141 WHITTIER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2173
Practice Address - Country:US
Practice Address - Phone:562-789-0444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4178213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E41780Medicaid
CA000E41780Medicaid
CAU79483Medicare UPIN