Healthcare Provider Details

I. General information

NPI: 1780331348
Provider Name (Legal Business Name): BEST PODIATRY ON BRAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2022
Last Update Date: 03/03/2022
Certification Date: 03/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 S BRAND BLVD
GLENDALE CA
91204-1701
US

IV. Provider business mailing address

319 S BRAND BLVD
GLENDALE CA
91204-1701
US

V. Phone/Fax

Practice location:
  • Phone: 818-240-0006
  • Fax: 818-240-0038
Mailing address:
  • Phone: 818-240-0006
  • Fax: 818-240-0038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN TEHRANI
Title or Position: CEO
Credential: MD
Phone: 818-240-0006