Basic Information
| Provider Information | |||||||||
| NPI: | 1912402181 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TREAT MEDICAL INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2110 W SUNSET BLVD STE M | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900263125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8338732852 | ||||||||
| FaxNumber: | 8338732852 | ||||||||
| Practice Location | |||||||||
| Address1: | 2110 W SUNSET BLVD STE M | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900263125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8338732852 | ||||||||
| FaxNumber: | 8338732852 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2018 | ||||||||
| LastUpdateDate: | 03/28/2018 | ||||||||
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| AuthorizedOfficialLastName: | MANDAVIA | ||||||||
| AuthorizedOfficialFirstName: | SUJAL | ||||||||
| AuthorizedOfficialMiddleName: | SHARAD | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8338732852 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.