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NPI Code Detail

MEDICARE: DR. AGIM GASHI DPM

MEDICARE: DR. AGIM GASHI DPM
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
1213ES0103XFoot & Ankle Surgery PodiatristE4567CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1E4567OTHERCAMEICARE LICENSE

General Provider Information

NPI Number : 1760436596
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AGIM GASHI DPM
Provider Business Mailing Address
First Line : 9100 SO SEPULVEDA BLVD
Second Line : SUITE 100
City : LOS ANGELES
State : CA
Zip : 90045-4849
Country : US
Telephone Number : 310-645-3338
Fax Number : 310-645-0823
Provider Business Practice Location Address
First Line : 3149 AMBASSADOR CAFFERY PKWY
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-7209
Country : US
Telephone Number : 337-706-3415
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 09/28/2023

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