Healthcare Provider Details

I. General information

NPI: 1699298539
Provider Name (Legal Business Name): ALBERT ABRAHAM ELHIANI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2017
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9233 W PICO BLVD STE 201
LOS ANGELES CA
90035-1385
US

IV. Provider business mailing address

9233 W PICO BLVD STE 201
LOS ANGELES CA
90035-1385
US

V. Phone/Fax

Practice location:
  • Phone: 424-279-9332
  • Fax: 424-279-9332
Mailing address:
  • Phone: 424-279-9332
  • Fax: 424-279-9332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: