Provider Demographics
NPI:1861722134
Name:HORMOZI, JONES (DPM)
Entity type:Individual
Prefix:DR
First Name:JONES
Middle Name:
Last Name:HORMOZI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17412 VENTURA BLVD STE 31
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3827
Mailing Address - Country:US
Mailing Address - Phone:818-981-1900
Mailing Address - Fax:866-254-5997
Practice Address - Street 1:18840 VENTURA BLVD STE 211
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356
Practice Address - Country:US
Practice Address - Phone:818-981-1900
Practice Address - Fax:866-254-5997
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE 4856213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery