Provider Demographics
NPI:1396782660
Name:FIRST PRIZE INC
Entity type:Organization
Organization Name:FIRST PRIZE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OLEG
Authorized Official - Middle Name:
Authorized Official - Last Name:LEYTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-462-5277
Mailing Address - Street 1:1540 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7014
Mailing Address - Country:US
Mailing Address - Phone:323-462-5277
Mailing Address - Fax:323-462-5279
Practice Address - Street 1:1540 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-7014
Practice Address - Country:US
Practice Address - Phone:323-462-5277
Practice Address - Fax:323-462-5279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG344Medicare ID - Type UnspecifiedIDTF