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General NPI Number Information
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NPI Number | 1992136683
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Entity Type | Individual
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Provider Name | MEHRNAZ KOUHKAN DPM
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Gender | Female
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Dates
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Enumeration Date | 12/05/2013
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 23928 LYONS AVE STE 204
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City | NEWHALL
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State | CA
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Zip | 91321-2455
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Country | US
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Telephone | 310-347-5088
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Fax |
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Provider Business Mailing Address
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Address Line | 11690 MONTANA AVE APT 105
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City | LOS ANGELES
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State | CA
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Zip | 90049-4671
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Country | US
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Telephone | 310-838-6872
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | E3152
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC006423
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License Number State | PA
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