Provider Demographics
NPI:1598132466
Name:SHAKOCAT INC.
Entity Type:Organization
Organization Name:SHAKOCAT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LILY
Authorized Official - Middle Name:
Authorized Official - Last Name:SATANOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-623-8500
Mailing Address - Street 1:6517 BELLAIRE AVE
Mailing Address - Street 2:
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-1240
Mailing Address - Country:US
Mailing Address - Phone:818-355-2795
Mailing Address - Fax:
Practice Address - Street 1:6517 BELLAIRE AVE
Practice Address - Street 2:
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1240
Practice Address - Country:US
Practice Address - Phone:818-355-2795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42488261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy