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Shadi Yadegaran

  • Female

Medical Specialty

Professional ID

  • NPI: 1568886075
  • PECOS ID: 5395966428
  • Enrollment ID: I20141014002335
  • Credential(MD, DO, DPM):
  • Medical School: California College Podiatric Medicine
  • Medical School Graduation Year: 2008

Hospital Service

  • Hospital CCN1: 050235
  • Business Name (LBN)1: Providence Saint Joseph Medical Ctr

Medical Practices

  • Organization Name: Professional Foot And Ankle Center Inc
  • Group Practice ID assigned by PECOS: 3173743606
  • Number of Group Practice member: 2

Location

  • Address1: 2601 W Alameda Ave
  • Address2: Suite 208
  • City: Burbank
  • State: California
  • Zip Code: 91505
  • Phone Number: (818)558-7075

Medicare

  • Medicare Assignment: Yes
  • Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
  • Used Electronic health record (EHR):