Provider Demographics
NPI:1720412281
Name:S S MEDICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:S S MEDICAL ASSOCIATES INC
Other - Org Name:S&S MEDICAL ASSOCIATES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:STILES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-705-1200
Mailing Address - Street 1:18370 BURBANK BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2804
Mailing Address - Country:US
Mailing Address - Phone:818-705-1200
Mailing Address - Fax:818-691-2920
Practice Address - Street 1:18370 BURBANK BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2804
Practice Address - Country:US
Practice Address - Phone:818-705-1200
Practice Address - Fax:818-691-2920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-02
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB210894Medicare PIN