Healthcare Provider Details

I. General information

NPI: 1063554475
Provider Name (Legal Business Name): FOYGELMAN PODIATRIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7559A SANTA MONICA BLVD
WEST HOLLYWOOD CA
90046-6406
US

IV. Provider business mailing address

4900 TARZANA WOODS DR
TARZANA CA
91356-4429
US

V. Phone/Fax

Practice location:
  • Phone: 818-633-3338
  • Fax:
Mailing address:
  • Phone: 818-633-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4387
License Number StateCA

VIII. Authorized Official

Name: DR. ALEKSANDR FOYGELMAN
Title or Position: CEO
Credential: D.P.M.
Phone: 818-633-3338