Healthcare Provider Details

I. General information

NPI: 1447480322
Provider Name (Legal Business Name): DAVID J SLUTSKY MD A PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2009
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 TORRANCE BLVD STE 190
TORRANCE CA
90503-4539
US

IV. Provider business mailing address

4201 TORRANCE BLVD STE 190
TORRANCE CA
90503-4539
US

V. Phone/Fax

Practice location:
  • Phone: 310-413-6616
  • Fax:
Mailing address:
  • Phone: 310-413-6616
  • Fax: 310-618-8445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberG60377
License Number StateCA

VIII. Authorized Official

Name: DAVID SLUTSKY
Title or Position: OWNER
Credential:
Phone: 310-413-6616