# PROGRESSIVE FOOT AND ANKLE INSTITUTE PC

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

## Provider details

- **NPI number:** 1689009227
- **Authorized official:** ALEKSANDER VALENTINOVICH LAVRENOV D.P.M (PRESIDENT)
- **Authorized official phone:** (917) 687-7528

## Contact information

- **Practice address:** 3030 W TEMPLE ST, STE 106, LOS ANGELES, CA 90026-4533
- **Practice address phone:** (213) 387-9251
- **Practice address fax:** (213) 387-9241
- **Mailing address:** 20548 VENTURA BLVD, APT 217, WOODLAND HILLS, CA 91364-6225
- **Mailing address phone:** (917) 687-7528
- **Mailing address fax:** (213) 387-9241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | E5019 | CA | Yes |

## Other

- **Enumeration date:** 09/13/2013
- **Last updated:** 09/13/2013