Organization
LOS GATOS PODIATRY GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AZAR DASTGAH DPM (PRESIDENT)
(408) 358-2250
Entity
Organization
Contact information
Practice address
14651 S BASCOM AVE, SUITE 215, LOS GATOS, CA 95032-2014
(408) 358-2250
(408) 358-2258
Mailing address
14651 S BASCOM AVE, SUITE 215, LOS GATOS, CA 95032-2014
(408) 358-2250
(408) 358-2258
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4916
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E4988
CA
Other
Enumeration date
06/11/2012
Last updated
02/27/2013
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