institution
P.b. Nikravesh Dpm, Apc
Foot & Ankle Surgery Podiatrist in Los Angeles, California
NPI 1083969018

P.b. Nikravesh Dpm, Apc is a Foot & Ankle Surgery Podiatrist based in Los Angeles, CA and is specialized in Foot & Ankle Surgery. P.b. Nikravesh Dpm, Apc practices in Los Angeles, CA. The NPI Number for P.b. Nikravesh Dpm, Apc is 1083969018 and holds a License No. E4103 (California).

The current practice location address for P.b. Nikravesh Dpm, Apc is 6404 Wilshire Blvd Ste 600, Los Angeles, CA and can be reached out via phone at 323-782-8586 and via fax at 323-782-8528.

Location: 6404 Wilshire Blvd Ste 600, Los Angeles, CA, 90048-5501
institution
Provider Profile Details
NPI Number
1083969018
Provider Name
P.b. Nikravesh Dpm, Apc
Credential
Provider Entity Type
Organization
Address
6404 Wilshire Blvd Ste 600, Los Angeles, CA, 90048-5501
Phone Number
323-782-8586
Fax Number
323-782-8528
Provider Enumeration Date
07/16/2012
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000E41032 05 CA
E4103 01 CA MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
6404 Wilshire Blvd Ste 600
City
State
Zip
90048-5501
Phone Number
323-782-8586
Fax Number
323-782-8528
person
Provider Business Mailing Address Details
Address
6404 Wilshire Blvd Ste 600
City
State
Zip
90048-5501
Phone Number
323-782-8586
Fax Number
323-782-8528
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Primary Podiatric Medicine
Taxonomy
License No.
E4103 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
E4103 (California)
Definition
Definition to come...
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