Provider Demographics
NPI:1780993287
Name:DR. HALEH TOUTOUNCHI DPM, INC.
Entity type:Organization
Organization Name:DR. HALEH TOUTOUNCHI DPM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HALEH
Authorized Official - Middle Name:
Authorized Official - Last Name:TOUTOUNCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-220-7696
Mailing Address - Street 1:4205 CAHUENGA BLVD APT 307
Mailing Address - Street 2:
Mailing Address - City:TOLUCA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:91602-2881
Mailing Address - Country:US
Mailing Address - Phone:713-376-2285
Mailing Address - Fax:
Practice Address - Street 1:6650 RESEDA BLVD.
Practice Address - Street 2:# 101A
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-8400
Practice Address - Country:US
Practice Address - Phone:818-708-7668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE 4804213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty