MEDICARE: BELA MASLOBODSKY

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	332B00000X	Durable Medical Equipment & Medical Supplies	103146	CA

General Provider Information

NPI Number	:	1508932567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELA MASLOBODSKY

Provider Business Mailing Address
First Line	:	18305 SHERMAN WAY # 27
Second Line	:
City	:	RESEDA
State	:	CA
Zip	:	91335-4425
Country	:	US
Telephone Number	:	818-345-8272
Fax Number	:	818-345-8272

Provider Business Practice Location Address
First Line	:	18305 SHERMAN WAY # 27
Second Line	:
City	:	RESEDA
State	:	CA
Zip	:	91335-4425
Country	:	US
Telephone Number	:	818-345-8272
Fax Number	:	818-345-8272

Authorized Official
Title or Position	:	OWNER
Name	:	BELA MASLOBODSKY
Credential	:
Telephone Number	:	818-345-8272

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	06/12/2008

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Directions to “BELA MASLOBODSKY ” Practice Location

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