Organization
JASON KHADAVI DPM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON KHADAVI (PRESIDENT)
(818) 642-3660
Entity
Organization
Contact information
Practice address
16661 VENTURA BLVD STE 820, ENCINO, CA 91436-4801
(424) 377-0441
Mailing address
10707 MISSOURI AVE APT 301, LOS ANGELES, CA 90025-6360
(818) 642-3660
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
E5064
CA
Other
Enumeration date
01/18/2018
Last updated
10/01/2020
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