Provider Demographics
NPI:1437357050
Name:ADVANCED FOOT AND ANKLE CENTER, INC.
Entity type:Organization
Organization Name:ADVANCED FOOT AND ANKLE CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEDRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ASLMAND
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:562-426-0376
Mailing Address - Street 1:2333 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-3025
Mailing Address - Country:US
Mailing Address - Phone:562-426-0376
Mailing Address - Fax:
Practice Address - Street 1:2333 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-3025
Practice Address - Country:US
Practice Address - Phone:562-426-0376
Practice Address - Fax:562-424-4128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4403213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E44030OtherBLUE SHIELD
CA1558454264Medicare NSC
CAW17384Medicare PIN
CAWE4403AMedicare PIN
CA000E44030OtherBLUE SHIELD
CAU88942Medicare UPIN