Provider Demographics
NPI:1043252513
Name:ASHKAN SOLEYMANI, DPM, INC
Entity type:Organization
Organization Name:ASHKAN SOLEYMANI, DPM, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHKAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLEYMANI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:310-925-2022
Mailing Address - Street 1:PO BOX 17899
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90209-3899
Mailing Address - Country:US
Mailing Address - Phone:310-925-2022
Mailing Address - Fax:
Practice Address - Street 1:575 E HARDY ST
Practice Address - Street 2:SUITE 212
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4036
Practice Address - Country:US
Practice Address - Phone:310-590-2333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASHKAN SOLEYMANI, DPM, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-11
Last Update Date:2020-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4401213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E44011Medicaid
CADG3843OtherRAILROAD MEDICARE
CAP00432891OtherRAILROAD MEDICARE
CA000E44010Medicaid
CA000E44010Medicaid
CAP00432891OtherRAILROAD MEDICARE