JONATHAN TAVAKOLI DPM NPI 1467960690

NPI Information

NPI: 1467960690
Provider Name: JONATHAN TAVAKOLI, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

Organization: OMEGA PODIATRY INC

PECOS Registration: Yes

Address:
11932 GOSHEN AVE PH 1
LOS ANGELES, CA
ZIP 90049
Phone: (310) 651-0098
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Jonathan Tavakoli, DPM is a foot and ankle surgery podiatrist in Los Angeles, CA with 9 years of experience. Jonathan Tavakoli, DPM NPI is 1467960690. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11932 GOSHEN AVE PH 1
LOS ANGELES, CA
ZIP 90049-309
Phone: (310) 651-0098

The NPI 1467960690 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 1/22/2018 and was last updated on 1/22/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	E5422	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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