Organization
LORIS YADEGARIAN DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORIS YADEGARIAN DPM (SOLE PROPRIETOR)
(818) 988-6880
Entity
Organization
Contact information
Practice address
14600 SHERMAN WAY, SUITE 210, VAN NUYS, CA 91405-2269
(818) 988-6880
(818) 988-3289
Mailing address
14600 SHERMAN WAY, SUITE 210, VAN NUYS, CA 91405-2269
(818) 988-6880
(818) 988-3289
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4376
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000E43760
MEDI CAL EDS
CA
05
—
000E43760
—
CA
01
—
000E43761
MEDI CAL EDS
CA
Enumeration date
11/02/2007
Last updated
05/09/2008
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