Provider Demographics
NPI:1982140224
Name:LPR PODIATRY, INC.
Entity Type:Organization
Organization Name:LPR PODIATRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSIHI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-409-9912
Mailing Address - Street 1:311 N VERDUGO RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-3944
Mailing Address - Country:US
Mailing Address - Phone:818-409-9912
Mailing Address - Fax:818-553-1720
Practice Address - Street 1:311 N VERDUGO RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-3944
Practice Address - Country:US
Practice Address - Phone:818-409-9912
Practice Address - Fax:818-553-1720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty