Organization Active NPI

SLS Medical Center PMC

  • Family Medicine Physician
  • Encino, CA
National Provider Identifier
1174479539
Registry record updated Mar 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SLS MEDICAL CENTER PMC
Practice address
16661 Ventura Blvd Ste 720
Encino, CA 91436-1914
Phone
(747) 264-1424
Fax
(747) 264-1755
NPI assigned
Mar 9, 2026
Last updated
Mar 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sona Garayev
Title
Administrator
Phone
(310) 500-0025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

16661 Ventura Blvd Ste 720
Encino, CA 91436-1914

Mailing address

16661 Ventura Blvd Ste 720
Encino, CA 91436-1914
Phone (747) 264-1424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260507001039 CA Part B Supplier - Clinic/Group Practice 2860960994 Receives reassigned benefits from 3 practitioners
Practice locations: Encino, CA

National Provider Directory

National Provider Directory

Locations

16661 Ventura Blvd
Bldg 720
Encino, CA 91436

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774051200000",
    "number": "1174479539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16661 VENTURA BLVD STE 720",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361914",
            "telephone_number": "747-264-1424",
            "fax_number": "747-264-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16661 VENTURA BLVD STE 720",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361914",
            "telephone_number": "747-264-1424",
            "fax_number": "747-264-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLS MEDICAL CENTER PMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-09",
        "last_updated": "2026-03-21",
        "certification_date": "2026-03-21",
        "status": "A",
        "authorized_official_last_name": "GARAYEV",
        "authorized_official_first_name": "SONA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "310-500-0025"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.