Provider Demographics
NPI:1447556204
Name:ASRAT, KIBROM GHIRMAY (DPM)
Entity Type:Individual
Prefix:DR
First Name:KIBROM
Middle Name:GHIRMAY
Last Name:ASRAT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13132 STUDEBAKER RD STE 1
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-2558
Mailing Address - Country:US
Mailing Address - Phone:562-868-0700
Mailing Address - Fax:562-888-6023
Practice Address - Street 1:13132 STUDEBAKER RD STE 1
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2558
Practice Address - Country:US
Practice Address - Phone:562-868-0700
Practice Address - Fax:562-888-6023
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4925213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery