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Organization

UNIVERSITY FOOT AND ANKLE INSTITUTE A PODIATRIC SURGICAL CENTER

Active
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Organization

UNIVERSITY FOOT AND ANKLE INSTITUTE A PODIATRIC SURGICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BABAK BARAVARIAN DPM (PARTNER PODIATRY)
(310) 828-0011
Entity
Organization

Contact information

Practice address
1101 SEPULVEDA BLVD, SUITE 104, MANHATTAN BEACH, CA 90266
(310) 828-0011
(310) 828-2001
Mailing address
2121 WILSHIRE BLVD, SUITE 101, SANTA MONICA, CA 90403
(310) 828-0011
(310) 828-2001

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4186
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E3141
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E4693
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1114147444
NPI
CA
Enumeration date
08/24/2006
Last updated
02/11/2008
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