Provider Demographics
NPI:1376013730
Name:FATAH PARAMOLE DPM LLC
Entity Type:Organization
Organization Name:FATAH PARAMOLE DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FATAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PARAMOLE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-312-0613
Mailing Address - Street 1:2517 W 42ND ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-3939
Mailing Address - Country:US
Mailing Address - Phone:917-312-0613
Mailing Address - Fax:
Practice Address - Street 1:561 N ALTA AVE STE A
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-3200
Practice Address - Country:US
Practice Address - Phone:559-596-5498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty