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Organization
NEW AGE FOOT AND ANKLE PODIATRY PC
Active
Organization
NEW AGE FOOT AND ANKLE PODIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEKSANDER VALENTINOVICH LAVRENOV D.P.M. (PRESIDENT)
(917) 687-7528
Entity
Organization
Contact information
Practice address
16935 VANOWEN ST, SUITE E, VAN NUYS, CA 91406-4595
(917) 687-7528
Mailing address
20548 VENTURA BLVD, SUITE 217, WOODLAND HILLS, CA 91364-6225
(917) 687-7528
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E 5019
CA
Other
Enumeration date
04/09/2014
Last updated
06/04/2014
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