Healthcare Provider Details

I. General information

NPI: 1396074993
Provider Name (Legal Business Name): ARMIN FERADOUNI NEJAD DPM, A PROFESSIONAL PODIATRIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2009
Last Update Date: 12/11/2009
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

22727 MULHOLLAND DR
WOODLAND HILLS CA
91364-4943
US

V. Phone/Fax

Practice location:
  • Phone: 310-791-1092
  • Fax: 310-791-1087
Mailing address:
  • Phone: 818-571-5358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License NumberE4767
License Number StateCA

VIII. Authorized Official

Name: DR. ARMIN FERADOUNI
Title or Position: OWNER
Credential: DPM
Phone: 818-571-5358