Organization
INTERNATIONAL CENTER FOR MINIMALLY INVASIVE FOOT SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALIREZA KHOSROABADI DPM (CEO)
(818) 408-2800
Entity
Organization
Contact information
Practice address
23164 VENTURA BLVD, WOODLAND HILLS, CA 91364-1101
(818) 914-5686
(818) 408-2452
Mailing address
23164 VENTURA BLVD, WOODLAND HILLS, CA 91364-1101
(818) 914-5686
(818) 914-4573
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4728
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841490620
NPI
CA
01
—
E4728
LICENSE
CA
Enumeration date
02/26/2016
Last updated
02/26/2025
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