Provider Demographics
NPI:1396074993
Name:ARMIN FERADOUNI NEJAD DPM, A PROFESSIONAL PODIATRIC CORPORATION
Entity type:Organization
Organization Name:ARMIN FERADOUNI NEJAD DPM, A PROFESSIONAL PODIATRIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FERADOUNI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-571-5358
Mailing Address - Street 1:22727 MULHOLLAND DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-4943
Mailing Address - Country:US
Mailing Address - Phone:818-571-5358
Mailing Address - Fax:
Practice Address - Street 1:3655 LOMITA BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3931
Practice Address - Country:US
Practice Address - Phone:310-791-1092
Practice Address - Fax:310-791-1087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4767261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric