Provider Demographics
NPI:1457789190
Name:FOOT & ANKLE DOCTORS OF BEVERLY HILLS, A PROFESSIONAL CORP
Entity type:Organization
Organization Name:FOOT & ANKLE DOCTORS OF BEVERLY HILLS, A PROFESSIONAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FARSHID
Authorized Official - Middle Name:
Authorized Official - Last Name:NEJAD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:310-652-3668
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:310-652-3668
Mailing Address - Fax:310-652-3669
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:310-652-3668
Practice Address - Fax:310-652-3669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4490213ES0103X
CAE4525213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty