MEDICARE: RONNY ALFANDARI DPM PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1033051750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONNY ALFANDARI DPM PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	4351 CHERRY HILLS LN
Second Line	:
City	:	TARZANA
State	:	CA
Zip	:	91356-5406
Country	:	US
Telephone Number	:	818-430-2592
Fax Number	:

Provider Business Practice Location Address
First Line	:	23622 CALABASAS RD STE 122
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-4144
Country	:	US
Telephone Number	:	747-207-4449
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RONNY ALFANDARI
Credential	:	DPM
Telephone Number	:	818-430-2592

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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