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General NPI Number Information
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NPI Number | 1053678078
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Entity Type | Organization
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Legal Business Name | UNIVERSAL FOOT AND ANKLE CARE, A PODIATRY CORPORATION
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Dates
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Enumeration Date | 04/16/2012
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Last Update Date | 04/16/2012
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Provider Practice Location Address
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Address Line | 11800 VALLEY BLVD
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City | EL MONTE
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State | CA
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Zip | 91732-3040
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Country | US
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Telephone | 818-723-7862
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 280748
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City | NORTHRIDGE
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State | CA
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Zip | 91328-0748
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAYMAN R HOSHYARSAR
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Credential | D.P.M.
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Telephone | 818-723-7862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4547
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License Number State | CA
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