Provider Demographics
NPI:1285513929
Name:STS CLINIC
Entity type:Organization
Organization Name:STS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUMANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-522-1737
Mailing Address - Street 1:22048 SHERMAN WAY STE 112
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1893
Mailing Address - Country:US
Mailing Address - Phone:818-522-1737
Mailing Address - Fax:
Practice Address - Street 1:22048 SHERMAN WAY STE 112
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1893
Practice Address - Country:US
Practice Address - Phone:818-522-1737
Practice Address - Fax:818-522-1737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care