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General NPI Number Information
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NPI Number | 1851492417
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Entity Type | Organization
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Legal Business Name | FOOT & ANKLE CLINIC INC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 02/02/2012
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Provider Practice Location Address
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Address Line | 23206 LYONS AVE STE 108
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City | NEWHALL
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State | CA
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Zip | 91321-2667
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Country | US
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Telephone | 661-288-2321
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Fax | 661-288-0378
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Provider Business Mailing Address
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Address Line | 23206 LYONS AVE STE 108
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City | NEWHALL
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State | CA
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Zip | 91321-1111
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Country | US
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Telephone | 661-288-2321
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Fax | 661-288-0378
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Authorized Official
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Title or Position | OWNER /PRESIDENT
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Name | DR. FREDERICK AVAKIAN
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Credential | DPM
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Telephone | 661-288-2321
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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 | E4191
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License Number State | CA
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