MEDICARE: KATAYOUN ABTIN DPM A PROFESSIONAL CORP

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	:	1316678162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATAYOUN ABTIN DPM A PROFESSIONAL CORP

Provider Business Mailing Address
First Line	:	1726 S BENTLEY AVE APT 302
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-4343
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1726 S BENTLEY AVE APT 302
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-4343
Country	:	US
Telephone Number	:	818-414-2300
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATAYOUN ABTIN
Credential	:	DPM
Telephone Number	:	310-739-7797

Provider Enumeration Date	:	06/22/2022
Last Update Date	:	06/22/2022

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