Jonathan Tavakoli DPM

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

JONATHAN TAVAKOLI DPM

Practice address

10518 Wilkins Ave
Los Angeles, CA 90024-6032

Phone

(310) 651-0098

NPI assigned

Aug 11, 2023

Organization subpart

No

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

Authorized official

Name

Jonathan Tavakoli, DPMNPI 1467960690

Title

Ceo

Phone

(310) 651-0098

Specialties & licenses 1

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.

• Jonathan Tavakoli, DPM

  • Foot & Ankle Surgery Podiatrist
  • Los Angeles, CA
  • NPI 1467960690
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1891478111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10518 WILKINS AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900246032",
            "telephone_number": "310-651-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10518 WILKINS AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900246032",
            "telephone_number": "310-651-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN TAVAKOLI DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-11",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "TAVAKOLI",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-651-0098",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatric Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, 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 Feb 13, 2024; 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.