Provider Demographics
NPI:1992443436
Name:CALABASAS PODIATRY GROUP
Entity type:Organization
Organization Name:CALABASAS PODIATRY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALIREZA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHOSROABADI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-914-5686
Mailing Address - Street 1:23164 VENTURA BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1101
Mailing Address - Country:US
Mailing Address - Phone:818-914-5686
Mailing Address - Fax:818-914-4573
Practice Address - Street 1:23164 VENTURA BLVD STE D
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1101
Practice Address - Country:US
Practice Address - Phone:818-914-5686
Practice Address - Fax:818-914-4573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty