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General NPI Number Information
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NPI Number | 1316725088
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Entity Type | Organization
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Legal Business Name | TAVAKALYAN PODIATRY PC
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 501 W GLENOAKS BLVD STE 10
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City | GLENDALE
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State | CA
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Zip | 91202-4039
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Country | US
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Telephone | 616-482-7890
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Fax | 855-203-0413
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Provider Business Mailing Address
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Address Line | 501 WEST GLENOAKS BLVD, SUITE 10, PMB 212
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City | GLENDALE
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State | CA
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Zip | 91202-2341
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Country | US
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Telephone | 616-482-7890
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Fax | 855-203-0413
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. KARINA TAVAKALYAN
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Credential | DPM
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Telephone | 616-482-7890
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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 |
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License Number State |
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