Organization
PROGRESSIVE FOOT AND ANKLE INSTITUTE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEKSANDER VALENTINOVICH LAVRENOV D.P.M (PRESIDENT)
(917) 687-7528
Entity
Organization
Contact information
Practice address
3030 W TEMPLE ST, STE 106, LOS ANGELES, CA 90026-4533
(213) 387-9251
(213) 387-9241
Mailing address
20548 VENTURA BLVD, APT 217, WOODLAND HILLS, CA 91364-6225
(917) 687-7528
(213) 387-9241
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E5019
CA
Other
Enumeration date
09/13/2013
Last updated
09/13/2013
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