Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | E1746 | CA |
NPI | 1417145525 |
---|---|
Provider Name | Dr. Larry J Slomowitz |
First Address | Westlake Village, CA 91361-1985 |
Second Address | Westlake Village, CA 91361-1929 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2007 |
Last Update Date | 17/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T11052 | (02) | CA |