MEDICARE: ALBERT ELHIANI DPM INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780215210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBERT ELHIANI DPM INC

Provider Business Mailing Address
First Line	:	9340 W PICO BLVD STE 2
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1255
Country	:	US
Telephone Number	:	510-457-1463
Fax Number	:	310-288-1774

Provider Business Practice Location Address
First Line	:	9233 W PICO BLVD STE 201
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1385
Country	:	US
Telephone Number	:	424-279-9332
Fax Number	:	424-279-9333

Authorized Official
Title or Position	:	CORPORATE OFFICER
Name	:	DR. ALBERT A ELHIANI
Credential	:	DPM
Telephone Number	:	424-279-9332

Provider Enumeration Date	:	02/03/2020
Last Update Date	:	05/25/2022

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Directions to “ALBERT ELHIANI DPM INC ” Practice Location

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