Provider Demographics
NPI:1457002958
Name:MILAD SEAN HEDAYAT, D.P.M., PC
Entity Type:Organization
Organization Name:MILAD SEAN HEDAYAT, D.P.M., PC
Other - Org Name:SHERMAN OAKS PODIATRIST GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MILAD
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:HEDAYAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-995-8228
Mailing Address - Street 1:4955 VAN NUYS BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1806
Mailing Address - Country:US
Mailing Address - Phone:949-292-5804
Mailing Address - Fax:
Practice Address - Street 1:4955 VAN NUYS BLVD STE 107
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1806
Practice Address - Country:US
Practice Address - Phone:949-292-5804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-16
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty