Organization
MAXIMA THERAPY AND SPEECH CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTON ZUBATOV B.S. (CEO)
(509) 430-1111
Entity
Organization
Contact information
Practice address
5217 ETIWANDA AVE, TARZANA, CA 91356-4335
(509) 430-1111
(818) 704-7898
Mailing address
3940 LAUREL CANYON BLVD, SUITE 456, STUDIO CITY, CA 91604-3709
(818) 287-8875
(818) 704-7898
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
SP 13829
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942364526
ECA
CA
Enumeration date
08/02/2010
Last updated
03/15/2011
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