Provider Demographics
NPI:1740332626
Name:LARRY J. SLOMOWITZ, DPM, A PODIATRY CORP
Entity type:Organization
Organization Name:LARRY J. SLOMOWITZ, DPM, A PODIATRY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SLOMOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-347-9940
Mailing Address - Street 1:7230 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1907
Mailing Address - Country:US
Mailing Address - Phone:818-347-9940
Mailing Address - Fax:
Practice Address - Street 1:7230 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1907
Practice Address - Country:US
Practice Address - Phone:818-347-9940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1746213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE00017460Medicaid
CAE00017460Medicaid
CAT11052Medicare UPIN