MEDICARE: SLS MEDICAL CENTER PMC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1174479539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLS MEDICAL CENTER PMC

Provider Business Mailing Address
First Line	:	16661 VENTURA BLVD STE 720
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-1914
Country	:	US
Telephone Number	:	747-264-1424
Fax Number	:	747-264-1755

Provider Business Practice Location Address
First Line	:	16661 VENTURA BLVD STE 720
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-1914
Country	:	US
Telephone Number	:	747-264-1424
Fax Number	:	747-264-1755

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SONA GARAYEV
Credential	:
Telephone Number	:	310-500-0025

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/10/2026

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Directions to “SLS MEDICAL CENTER PMC ” Practice Location

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