Individual
TYLER SZKLARSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N/A
Contact information
Practice address
16947 OTSEGO ST, ENCINO, CA 91316-3455
(818) 450-6436
Mailing address
16947 OTSEGO ST, ENCINO, CA 91316
(818) 450-6436
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91508375G01070
—
CA
01
—
XOF843051139
BLUECROSS BLUESHIELD
IL
Enumeration date
06/16/2021
Last updated
06/16/2021
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