Healthcare Provider Details

I. General information

NPI: 1477287316
Provider Name (Legal Business Name): ARTIN SHAKHBANDARYAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2022
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 BUENA VISTA ST STE 204
DUARTE CA
91010-1713
US

IV. Provider business mailing address

931 BUENA VISTA ST STE 204
DUARTE CA
91010-1713
US

V. Phone/Fax

Practice location:
  • Phone: 626-414-2609
  • Fax: 626-380-2738
Mailing address:
  • Phone: 626-414-2609
  • Fax: 626-380-2738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5898
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: