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General NPI Number Information
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NPI Number | 1396334108
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Entity Type | Organization
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Legal Business Name | LC FOOT AND ANKLE CARE INC
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Dates
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Enumeration Date | 01/15/2021
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Last Update Date | 01/15/2021
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Provider Practice Location Address
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Address Line | 7535 LAUREL CANYON BLVD
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-3149
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Country | US
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Telephone | 310-651-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 8737 BEVERLY BLVD STE 103
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1835
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Country | US
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Telephone | 310-651-3700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AFSHIN JAVAHERIAN
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Credential | DPM
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Telephone | 310-657-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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