Provider Demographics
NPI:1457395923
Name:DARDASHTI, DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:DARDASHTI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 WILSHIRE BLVD STE 280E
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3562
Mailing Address - Country:US
Mailing Address - Phone:310-940-9920
Mailing Address - Fax:
Practice Address - Street 1:9100 WILSHIRE BLVD STE 280E
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3562
Practice Address - Country:US
Practice Address - Phone:310-940-9920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4490213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00228540OtherRAILROAD MEDICARE
CAE4490OtherSOUTHERN MEDICARE/LIC NUM
CA000E44900OtherNORTHERN CA MEDICARE
CAW18953OtherSOUTHERN MEDICARE NUMBER
CAP00228540OtherRAILROAD MEDICARE
CAP00228540OtherRAILROAD MEDICARE
CAU96208Medicare UPIN
CA5458500001Medicare NSC