Provider Demographics
NPI:1376669424
Name:L SLONINSKY MD & M SANFORD MD, A MEDICAL GROUP
Entity Type:Organization
Organization Name:L SLONINSKY MD & M SANFORD MD, A MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LILIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SLONINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-854-3043
Mailing Address - Street 1:8631 W 3RD ST
Mailing Address - Street 2:SUITE 725E
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5901
Mailing Address - Country:US
Mailing Address - Phone:310-854-3043
Mailing Address - Fax:310-854-0201
Practice Address - Street 1:8631 W 3RD ST
Practice Address - Street 2:SUITE 725E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5901
Practice Address - Country:US
Practice Address - Phone:310-854-3043
Practice Address - Fax:310-854-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G359480Medicaid