Provider Demographics
NPI:1346650546
Name:SLS MEDICAL INC
Entity Type:Organization
Organization Name:SLS MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRICPLE
Authorized Official - Prefix:MR
Authorized Official - First Name:KAMRON
Authorized Official - Middle Name:
Authorized Official - Last Name:REZVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-413-6167
Mailing Address - Street 1:16060 VENTURA BLVD.
Mailing Address - Street 2:SUITE #105
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436
Mailing Address - Country:US
Mailing Address - Phone:310-413-6167
Mailing Address - Fax:310-861-0569
Practice Address - Street 1:15720 VENTURA BLVD.
Practice Address - Street 2:SUITE #232
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-905-7674
Practice Address - Fax:310-861-0569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies