Individual
MANSOUR NEJADRASOOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
14600 SHERMAN WAY STE 230, VAN NUYS, CA 91405
(818) 784-8420
(818) 785-0028
Mailing address
14600 SHERMAN WAY STE 230, VAN NUYS, CA 91405-2291
(818) 784-8420
(818) 785-0028
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
E4452
CA
213ES0131X
Foot Surgery Podiatrist
Primary
E4452
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6445430003
NORIDIAN SECOND PTAN FOR VAN NUYS CLINIC
CA
Enumeration date
08/13/2006
Last updated
08/29/2018
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