Healthcare Provider Details

I. General information

NPI: 1730269655
Provider Name (Legal Business Name): KOUROSH HAROUNIAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1832 W 7TH ST
LOS ANGELES CA
90057-4102
US

IV. Provider business mailing address

311 N ROBERTSON BLVD # 331
BEVERLY HILLS CA
90211-1705
US

V. Phone/Fax

Practice location:
  • Phone: 213-484-0040
  • Fax:
Mailing address:
  • Phone: 213-484-0040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE4362
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4362
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberE4362
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: