| Neuro Fitness Medical Corporation | |
|
18726 S Western Ave Ste 409 Gardena CA 90248-3858 | |
| (310) 819-8582 | |
| Not Available |
| Full Name | Neuro Fitness Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 18726 S Western Ave Ste 409, Gardena, California |
| Authorized Official Name and Position | Paul Joseph Sliskovich (OWNER) |
| Authorized Official Contact | 3108198582 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuro Fitness Medical Corporation 18726 S Western Ave Ste 409 Gardena CA 90248-3858 Ph: (310) 819-8582 | Neuro Fitness Medical Corporation 18726 S Western Ave Ste 409 Gardena CA 90248-3858 Ph: (310) 819-8582 |
| NPI Number | 1659072106 |
|---|---|
| Provider Enumeration Date | 03/13/2023 |
| Last Update Date | 04/13/2023 |
| Medicare PECOS PAC ID | 8325404585 |
|---|---|
| Medicare Enrollment ID | O20230614002253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659072106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Latesha T Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184018012 PECOS PAC ID: 1456635622 Enrollment ID: I20170412000924 |
| Provider Name | Paul Sliskovich |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1245892934 PECOS PAC ID: 1456680446 Enrollment ID: I20220715000318 |
| Provider Name | Tochi Nwachukwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285399949 PECOS PAC ID: 2264897958 Enrollment ID: I20230502003077 |
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