=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033051750
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RONNY ALFANDARI DPM PROFESSIONAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2026
-----------------------------------------------------
Last Update Date | 04/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6200 CANOGA AVE STE 410
-----------------------------------------------------
City | WOODLAND HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91367-2459
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 747-207-4449
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4351 CHERRY HILLS LN
-----------------------------------------------------
City | TARZANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91356-5406
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-430-2592
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | RONNY ALFANDARI
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 818-430-2592
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------