NPIMap

Organization Active NPI

Premium Podiatry, Inc.

  • Podiatrist
  • Encino, CA
National Provider Identifier
1467550897
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E1306 Issued in CA
Legal business name
PREMIUM PODIATRY, INC.
Practice address
5400 Balboa Blvd Ste 325
Encino, CA 91316-5226
Phone
(818) 782-0559
Fax
(818) 782-8308
NPI assigned
Sep 20, 2006
Last updated
Apr 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Authorized official

Name
Sara Arredondo
Title
Office Manager
Phone
(818) 782-0559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X E1306 CA Primary

Addresses

Primary practice location

5400 Balboa Blvd Ste 325
Encino, CA 91316-5226

Mailing address

5400 Balboa Blvd Ste 325
Encino, CA 91316-5226
Phone (818) 782-0559

Other practice location 1

6601 Rugby Ave Ste 100
Huntington Park, CA 90255-4040
Phone (323) 749-9770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090226000497 CA Part B Supplier - Clinic/Group Practice 6406912401 Receives reassigned benefits from 5 practitioners
Practice locations: Huntington Park, CA; Encino, CA
O20210923001743 CA DME Supplier - Physician - Podiatry 6406912401 Practice locations: Encino, CA

National Provider Directory

National Provider Directory

Locations

15243 Vanowen St
Ste 410
Van Nuys, CA 91405
Phone (818) 732-0559

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776038400000",
    "number": "1467550897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 BALBOA BLVD STE 325",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165226",
            "telephone_number": "818-782-0559",
            "fax_number": "818-782-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 BALBOA BLVD STE 325",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165226",
            "telephone_number": "818-782-0559",
            "fax_number": "818-782-8308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6601 Rugby Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Huntington Park",
            "state": "CA",
            "postal_code": "902554040",
            "country_code": "US",
            "telephone_number": "323-749-9770",
            "fax_number": "323-749-9771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIUM PODIATRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A",
        "authorized_official_last_name": "ARREDONDO",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "818-782-0559"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E1306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; 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.