Provider Demographics
NPI:1073159794
Name:JAFARY FOOT & ANKLE SPECIALISTS INC
Entity Type:Organization
Organization Name:JAFARY FOOT & ANKLE SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFARY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:909-297-8389
Mailing Address - Street 1:4706 SEPULVEDA BLVD APT 202
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2478
Mailing Address - Country:US
Mailing Address - Phone:909-297-8389
Mailing Address - Fax:
Practice Address - Street 1:4706 SEPULVEDA BLVD APT 202
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2478
Practice Address - Country:US
Practice Address - Phone:909-297-8389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric