Basic Information
| Provider Information | |||||||||
| NPI: | 1720548381 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SVERDLOV | ||||||||
| FirstName: | ARON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18685 MAIN ST STE 101-459 | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926481723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146971907 | ||||||||
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| Practice Location | |||||||||
| Address1: | 23860 HAWTHORNE BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905058201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107913064 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2019 | ||||||||
| LastUpdateDate: | 10/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator | 106S00000X | N |
No ID Information.