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General NPI Number Information
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NPI Number | 1710873187
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Entity Type | Organization
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Legal Business Name | NATIONAL FOOT AND ANKLE CENTER PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/13/2025
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 14981 NATIONAL AVE STE 2
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City | LOS GATOS
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State | CA
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Zip | 95032-2600
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Country | US
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Telephone | 408-884-5851
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Fax | 669-327-2659
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Provider Business Mailing Address
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Address Line | 14981 NATIONAL AVE STE 2
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City | LOS GATOS
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State | CA
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Zip | 95032-2600
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Country | US
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Telephone | 408-884-5851
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Fax | 669-327-2659
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Authorized Official
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Title or Position | PRESIDENT
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Name | FARANAK POURGHASEMI
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Credential | DPM
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Telephone | 408-884-5851
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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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