Provider Demographics
NPI:1194389023
Name:PROPER FIT DIABETIC SHOES
Entity Type:Organization
Organization Name:PROPER FIT DIABETIC SHOES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ARGISHTI
Authorized Official - Middle Name:
Authorized Official - Last Name:MADATYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-980-1927
Mailing Address - Street 1:10639 BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-2512
Mailing Address - Country:US
Mailing Address - Phone:818-980-1927
Mailing Address - Fax:818-980-1928
Practice Address - Street 1:10639 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-2512
Practice Address - Country:US
Practice Address - Phone:818-980-1927
Practice Address - Fax:818-980-1928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment