Provider Demographics
NPI:1851359830
Name:COMFORT IN STYLE, INC,
Entity Type:Organization
Organization Name:COMFORT IN STYLE, INC,
Other - Org Name:ARTHRITIS AND BACK STORE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDUARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-788-0977
Mailing Address - Street 1:17285 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4007
Mailing Address - Country:US
Mailing Address - Phone:818-788-0977
Mailing Address - Fax:818-788-0971
Practice Address - Street 1:17285 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4007
Practice Address - Country:US
Practice Address - Phone:818-788-0977
Practice Address - Fax:818-788-0971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102717332B00000X
CA17937332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03045GMedicaid
CA5355930001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER