Organization
SUNSET SHOE REPAIR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANI KOTELYAN (OWNER)
(323) 356-5397
Entity
Organization
Contact information
Practice address
8036 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90046-5009
(323) 654-7743
Mailing address
8036 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90046-5009
(323) 654-7743
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/24/2012
Last updated
05/24/2012
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