# MICHAELBASTANIDPM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407496318
- **Authorized official:** MICHAEL BASTANI DPM (OWNER)
- **Authorized official phone:** (917) 675-1045

## Contact information

- **Practice address:** 22 ODYSSEY STE 115, IRVINE, CA 92618-3188
- **Practice address phone:** (424) 256-8956
- **Mailing address:** 23785 EL TORO RD \# 450, LAKE FOREST, CA 92630-4762

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 01/08/2020
- **Last updated:** 01/08/2020