Patrick M. Jadali DPM Inc

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

PATRICK M. JADALI DPM INC

Practice address

24641 Coleford St
Lake Forest, CA 92630-3925

Phone

(949) 333-9626

NPI assigned

Apr 4, 2023

Last updated

Sep 28, 2023By 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

Patrick Jadali, DPMNPI 1467957563

Title

Ceo

Phone

(562) 285-7372

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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.

• Patrick Mehran Jadali, DPM

  • Foot & Ankle Surgery Podiatrist
  • Long Beach, CA
  • NPI 1467957563
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1295430528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24641 COLEFORD ST",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24641 COLEFORD ST",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303925",
            "telephone_number": "949-333-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK M. JADALI DPM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "JADALI",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-285-7372",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamora Mulan Parker
• Nessa Parkinen, D.C.
• Giselle Pascua
• Julia Alexandra Pastrana
• Sahil Hitesh Patadia, DDS
• Zeta Patti-Duran
• Jeffrey A Paulsen, D.C.
• Parnian Paymozd Yazdi, DMD
• Ashley Monique Paz, RN
• Pdic, Inc. (Professional Development Institute of California)

• Podiatric Clinic/Center in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Podiatric Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.