Provider Demographics
NPI:1568551901
Name:LASER THERAPY INC
Entity Type:Organization
Organization Name:LASER THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MALAMUD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-440-2040
Mailing Address - Street 1:201 S ALVARADO ST
Mailing Address - Street 2:SUITE 407
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-2320
Mailing Address - Country:US
Mailing Address - Phone:213-440-2040
Mailing Address - Fax:213-234-4516
Practice Address - Street 1:201 S ALVARADO ST
Practice Address - Street 2:SUITE 407
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2320
Practice Address - Country:US
Practice Address - Phone:213-440-2040
Practice Address - Fax:213-234-4516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051065Medicare ID - Type UnspecifiedAMBULATORY SURGICAL CENTE