Provider Demographics
NPI:1710873187
Name:NATIONAL FOOT AND ANKLE CENTER PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:NATIONAL FOOT AND ANKLE CENTER PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FARANAK
Authorized Official - Middle Name:
Authorized Official - Last Name:POURGHASEMI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:408-884-5851
Mailing Address - Street 1:14981 NATIONAL AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2600
Mailing Address - Country:US
Mailing Address - Phone:408-884-5851
Mailing Address - Fax:669-327-2659
Practice Address - Street 1:14981 NATIONAL AVE STE 2
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2600
Practice Address - Country:US
Practice Address - Phone:408-884-5851
Practice Address - Fax:669-327-2659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty