Provider Demographics
NPI:1114724515
Name:SYAMAK YAMINI DPM, PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:SYAMAK YAMINI DPM, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SYAMAK
Authorized Official - Middle Name:
Authorized Official - Last Name:YAMINI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-336-1356
Mailing Address - Street 1:18700 EDLEEN DR
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4809
Mailing Address - Country:US
Mailing Address - Phone:818-336-1356
Mailing Address - Fax:310-400-5666
Practice Address - Street 1:16550 VENTURA BLVD STE 406
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-5028
Practice Address - Country:US
Practice Address - Phone:818-336-1356
Practice Address - Fax:310-400-5666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty