Advanced Foot and Ankle Institute, a Podiatry Corporation

Organization Active NPI Foot & Ankle Surgery Podiatrist · Simi Valley, CA

NPI 1285856401 · NPPES record last updated Aug 25, 2008

Key facts

NPI
1285856401
Entity type
Organization (NPI type 2)
Primary specialty
Foot & Ankle Surgery Podiatrist 213ES0103X
License
E4547 (CA)
Legal business name
ADVANCED FOOT AND ANKLE INSTITUTE, A PODIATRY CORPORATION
Practice address
2840 E Los Angeles Ave
Simi Valley, CA 93065-3937
Phone
(805) 526-8360
NPI assigned
May 3, 2007
Organization subpart
No

Authorized official

Name
Dr. Payman Hoshyarsar
Title
President
Phone
(818) 723-7862

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080529000325 CA Part B Supplier - Clinic/Group Practice 2264502574 Receives reassigned benefits from 1 practitioner
Practice locations: El Monte, CA

National Provider Directory

Locations

10816 Valley Blvd
El Monte, CA 91731
Phone (626) 401-2775

1240 N Hacienda Blvd
Ste 106
La Puente, CA 91744

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP
213ES0103X E4547 CA Yes

Addresses

Primary practice location

2840 E Los Angeles Ave
Simi Valley, CA 93065-3937

Mailing address

PO Box 280748
Northridge, CA 91328-0748

Other identifiers

IdentifierTypeStateIssuer
W22394OtherPTAN
W22395OtherPTAN #

Other providers in Simi Valley, CA

All providers in Simi Valley, CA · Foot & Ankle Surgery Podiatrist in California

Sources for this page

Verify at the official NPI Registry.