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General NPI Number Information
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NPI Number | 1235330440
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Entity Type | Organization
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Legal Business Name | NATHAN A JAVARI DPM
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 11/14/2012
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Provider Practice Location Address
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Address Line | 231 WEST VERNON AVE # 109
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City | LOS ANGELES
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State | CA
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Zip | 90037
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Country | US
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Telephone | 323-231-7445
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Fax |
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Provider Business Mailing Address
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Address Line | 231 WEST VERNON AVE # 109
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City | LOS ANGELES
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State | CA
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Zip | 90037
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Country | US
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Telephone | 323-231-7445
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NATHAN AFSHIN JAVARI
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Credential | DPM
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Telephone | 323-231-7745
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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 | E4456
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License Number State | CA
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