Provider Demographics
NPI:1407068885
Name:CITY STATIONS, INC.
Entity Type:Organization
Organization Name:CITY STATIONS, INC.
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:NOVACEK
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED PEDORTHIST
Authorized Official - Phone:818-825-9439
Mailing Address - Street 1:1534 N MOORPARK RD
Mailing Address - Street 2:420
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5129
Mailing Address - Country:US
Mailing Address - Phone:818-825-9439
Mailing Address - Fax:866-317-1094
Practice Address - Street 1:1252 MADERA RD
Practice Address - Street 2:A1
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-4002
Practice Address - Country:US
Practice Address - Phone:805-579-8513
Practice Address - Fax:805-579-9462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5548310001Medicare ID - Type Unspecified