Provider Demographics
NPI:1770525065
Name:SOLEYMANI, ASHKAN (DPM)
Entity type:Individual
Prefix:DR
First Name:ASHKAN
Middle Name:
Last Name:SOLEYMANI
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:PO BOX 17899
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90209-3899
Mailing Address - Country:US
Mailing Address - Phone:310-925-2022
Mailing Address - Fax:
Practice Address - Street 1:18370 BURBANK BLVD STE 714
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2827
Practice Address - Country:US
Practice Address - Phone:818-769-8637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2020-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4401213ES0103X, 213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E44010Medicaid
CA000E44010Medicaid
CAU89458Medicare UPIN