Provider Demographics
NPI:1770763690
Name:SHAKOCAT INC.
Entity type:Organization
Organization Name:SHAKOCAT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REP
Authorized Official - Prefix:
Authorized Official - First Name:LEONID
Authorized Official - Middle Name:
Authorized Official - Last Name:SATANOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-922-2252
Mailing Address - Street 1:11333 MOORPARK ST # 204
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91602-2618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:818-301-5156
Practice Address - Street 1:124 N LA BREA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-2912
Practice Address - Country:US
Practice Address - Phone:818-922-2252
Practice Address - Fax:818-301-5156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18945Medicare PIN