Individual
MR. BORIS SKURATOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3454 PERLITA AVE, LOS ANGELES, CA 90039-1932
(323) 665-6893
(323) 658-5533
Mailing address
3454 PERLITA AVE, LOS ANGELES, CA 90039-1932
(323) 665-6893
(323) 658-5533
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
197608929
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-3194585
—
CA
Enumeration date
06/29/2015
Last updated
06/29/2015
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