Individual
LIA GORELISHVILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8340 FOOTHILL BLVD, SUNLAND, CA 91040-2849
(818) 446-0700
(818) 446-0064
Mailing address
8340 FOOTHILL BLVD, SUNLAND, CA 91040-2849
(818) 446-0700
(818) 446-0064
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5724590001
CA
Other
Enumeration date
12/15/2006
Last updated
07/09/2007
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