1659604684 NPI number — ASHKAN SOLEYMANI, DPM, INC

Table of content: (NPI 1659604684)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659604684 NPI number — ASHKAN SOLEYMANI, DPM, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASHKAN SOLEYMANI, DPM, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CEDARS FOOT & ANKLE CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659604684
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 17899
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEVERLY HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90209-3899
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-590-2333
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
575 E HARDY ST
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
INGLEWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90301-4036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-590-2333
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/09/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SOLEYMANI
Authorized Official First Name:
ASHKAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
310-590-2333

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  E4401 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000E44011 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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