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Organization
WEST COAST FOOT AND ANKLE INSTITUTE PC
Active
Organization
WEST COAST FOOT AND ANKLE INSTITUTE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEKSANDER VALENTINOVICH LAVRENOV D.P.M. (PRESIDENT)
(917) 687-7528
Entity
Organization
Contact information
Practice address
20548 VENTURA BLVD APT 217, WOODLAND HILLS, CA 91364-6470
(917) 687-7528
Mailing address
20548 VENTURA BLVD APT 217, WOODLAND HILLS, CA 91364-6470
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E5019
CA
Other
Enumeration date
11/26/2014
Last updated
11/26/2014
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