Provider Demographics
NPI:1497748818
Name:SWISS BALANCE INC
Entity Type:Organization
Organization Name:SWISS BALANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEFAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSER
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:310-458-9648
Mailing Address - Street 1:1260 15TH ST
Mailing Address - Street 2:STE 1402
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1135
Mailing Address - Country:US
Mailing Address - Phone:310-458-9648
Mailing Address - Fax:310-451-2002
Practice Address - Street 1:1260 15TH ST
Practice Address - Street 2:STE 1402
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1135
Practice Address - Country:US
Practice Address - Phone:310-458-9648
Practice Address - Fax:310-451-2002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-31
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ07389ZOtherBLUE SHIELD
CAGFC000200Medicaid
CA0160010001OtherPACIFICARE
CA0185960001Medicare ID - Type UnspecifiedBILLING NUMBER