Provider Demographics
NPI:1104998434
Name:KASHANIAN, ALONA (DPM)
Entity type:Individual
Prefix:
First Name:ALONA
Middle Name:
Last Name:KASHANIAN
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 1:9629 CRESTA DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-4003
Mailing Address - Country:US
Mailing Address - Phone:213-747-7272
Mailing Address - Fax:213-747-0471
Practice Address - Street 1:3984 SOUTH FIGUEROA STREET
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037
Practice Address - Country:US
Practice Address - Phone:213-747-7272
Practice Address - Fax:213-747-0471
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3975213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU56666Medicare UPIN
CA4846840001Medicare NSC