Healthcare Provider Details

I. General information

NPI: 1609046077
Provider Name (Legal Business Name): ARMIN FERADOUNI NEJAD D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2008
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3655 LOMITA BLVD SUITE 120
TORRANCE CA
90505-3931
US

IV. Provider business mailing address

3655 LOMITA BLVD SUITE 120
TORRANCE CA
90505-3931
US

V. Phone/Fax

Practice location:
  • Phone: 310-791-1092
  • Fax: 310-791-1087
Mailing address:
  • Phone: 310-791-1092
  • Fax: 310-791-1087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4767
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: