Provider Demographics
NPI:1396984621
Name:KAZAK MARS INC
Entity type:Organization
Organization Name:KAZAK MARS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SADOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-296-1551
Mailing Address - Street 1:7037 HAYVENHURST AVE
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3802
Mailing Address - Country:US
Mailing Address - Phone:818-375-1033
Mailing Address - Fax:818-375-1038
Practice Address - Street 1:7037 HAYVENHURST AVE
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3802
Practice Address - Country:US
Practice Address - Phone:818-375-1033
Practice Address - Fax:818-375-1038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier