Diabetic Neuropathy & Footcare Institute of Southern California

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

DIABETIC NEUROPATHY & FOOTCARE INSTITUTE OF SOUTHERN CALIFORNIA

Practice address

18411 Clark St
Suite 105
Tarzana, CA 91356-3506

Phone

(818) 345-3338

Fax

(818) 345-3363

NPI assigned

Jan 26, 2007

Last updated

Nov 26, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Avron Daniller, M.D.NPI 1952457673

Title

President

Phone

(818) 345-3338

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Avron Daniller, M.D.

  • Plastic Surgery Physician
  • Tarzana, CA
  • NPI 1952457673
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416960000000",
    "number": "1043366776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18411 CLARK ST",
            "address_2": "SUITE 105",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563506",
            "telephone_number": "818-345-3338",
            "fax_number": "818-345-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18411 CLARK ST",
            "address_2": "SUITE 105",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563506",
            "telephone_number": "818-345-3338",
            "fax_number": "818-345-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC NEUROPATHY & FOOTCARE INSTITUTE OF SOUTHERN CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2014-11-26",
        "status": "A",
        "authorized_official_last_name": "DANILLER",
        "authorized_official_first_name": "AVRON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-345-3338",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.