NEW AGE FOOT AND ANKLE PODIATRY PC (NPI# 1710302450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710302450 |
| Entity Type | Organization |
| Organization Name | NEW AGE FOOT AND ANKLE PODIATRY PC |
| Practice Address |
705 Ivy Street Glendale CA 91204 |
| Mailing Address |
20548 Ventura Blvd Apt 217 Woodland Hills CA 91364-6225 |
| Practice Telephone | 9176877528 |
| Mailing Telephone | 9176877528 |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2014-03-04 |
| Authorized Official Name | DR. ALEKSANDER V LAVRENOV (PRESIDENT) |
| Authorized Official Telephone | 9176877528 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
E 5019 | CA | Podiatric Medicine & Surgery Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710306501 | New Age Foot and Ankle Podiatry PC | Podiatrist | 16935 Vanowen St, Suite E, Van Nuys, CA 91406-4595 | 2014-04-09 |
| Street Address |
705 IVY STREET |
| City | GLENDALE |
| State | CA |
| Zip Code | 91204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558997387 | Hope & Trust Trading LLC | Radiology | 318 W Colorado St #2, Glendale, CA 91204 | 2020-03-12 |
| 1972133387 | Yusuf Toliver | Counselor | 1027 S Central Ave, Suite 200, Glendale, CA 91204 | 2020-01-24 |
| 1538633136 | Pathology La Inc. | Clinical Medical Laboratory | 4634 San Fernando Rd., Same As Above, Glendale, CA 91204 | 2019-01-16 |
| 1295254050 | Glendale Back and Pain Center | Neurological Surgery | 710 S. Central Ave, Suite 240, Glendale, CA 91204 | 2017-09-13 |
| 1285163568 | Ez Trans, Inc. | Transportation Broker | 1626 S. Central Ave., Glendale, CA 91204 | 2017-06-08 |
| 1194254474 | Jenny Chung | Pharmacist | 3943 San Fernando Road, Glendale, CA 91204 | 2017-06-08 |
| 1396111886 | Fresenius Medical Care Glendale, LLC | Clinic/Center | 623 S Central Ave, Glendale, CA 91204 | 2015-08-19 |
| 1124454376 | Alber K. Karamanoukian Medical Clinic, Inc. | Clinic/Center | 810 S. Central Avenue, Suite 100, Glendale, CA 91204 | 2013-09-19 |
| 1548521156 | Glendale Plastic and Reconstructive Surgery Inc. | Plastic Surgery | 1500 S. Central Ave. #126, Glendale, CA 91204 | 2012-05-31 |
| 1134492754 | Susan Catherine Traylor | Speech-Language Pathologist | 1420 South Central Ave, Glendale, CA 91204 | 2012-02-13 |
| Find all providers in zip 91204 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467072090 | Foot & Ankle Specialists of Arizona | Podiatrist | 5681 W Beverly Ln Ste 100a, Glendale, AZ 85306-9800 | 2020-04-23 |
| 1609366533 | Podiatric Physicians of Arizona, Inc. | Podiatrist | 11851 N 51st Ave Ste D120, Glendale, AZ 85304-2839 | 2018-05-16 |
| 1790218550 | Noubar Varderessian | Podiatrist | 1122 N Columbus Ave, Apt. 2, Glendale, CA 91202-3241 | 2017-04-09 |
| 1659721850 | Samvel Keshishyan | Podiatrist | 1339 N Columbus Ave Unit 311, Glendale, CA 91202-3875 | 2016-06-17 |
| 1639583388 | Jamila Butcher | Podiatrist | 5605 W Eugie Ave Ste 102, Glendale, AZ 85304-1273 | 2014-06-19 |
| 1710173489 | Glendale Foot & Ankle Podiatry Center, Inc. | Podiatrist | 1030 S Glendale Ave Ste 403, Glendale, CA 91205-2866 | 2007-09-17 |
| 1760564272 | Hermoz B Ayvazian | Podiatrist | 110 S Adams St, Glendale, CA 91205-1312 | 2006-10-20 |
| 1467567883 | Rajesh Praful Daulat | Podiatrist | 6677 W Thunderbird Rd Ste J171-172, Glendale, AZ 85306-3732 | 2006-08-19 |
| 1780606764 | Allen Massihi | Podiatrist | 311 N Verdugo Rd, Glendale, CA 91206-3944 | 2006-07-25 |
| 1952343808 | Philip R Shupe | Podiatrist | 1530 E Chevy Chase Dr, Suite 107, Glendale, CA 91206-4163 | 2006-06-12 |
| Find all providers in GLENDALE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.