Healthcare Provider Details

I. General information

NPI: 1487227302
Provider Name (Legal Business Name): SAMIRAS SOFT TOUCH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8730 GLENOAKS BLVD STE 2
SUN VALLEY CA
91352-2801
US

IV. Provider business mailing address

8730 GLENOAKS BLVD STE 2
SUN VALLEY CA
91352-2801
US

V. Phone/Fax

Practice location:
  • Phone: 818-960-7171
  • Fax: 818-960-7177
Mailing address:
  • Phone: 818-960-7171
  • Fax: 818-960-7177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: SAMIRA MEHRIZI
Title or Position: PRESIDENT
Credential: DPM
Phone: 818-960-7171