Healthcare Provider Details

I. General information

NPI: 1942238944
Provider Name (Legal Business Name): LILLIAN P SLONINSKY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 08/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD.
LOS ANGELES CA
90048-1865
US

IV. Provider business mailing address

PO BOX 512717
LOS ANGELES CA
90051-0717
US

V. Phone/Fax

Practice location:
  • Phone: 310-854-3043
  • Fax: 310-854-0201
Mailing address:
  • Phone: 310-854-3043
  • Fax: 310-854-0201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA33562
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: