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Organization
MEDICALSTATIONSUPPLY
Active
Organization
MEDICALSTATIONSUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL AZIZI (TREASURER)
(310) 279-0642
Entity
Organization
Contact information
Practice address
1143 S LOS ANGELES ST, LOS ANGELES, CA 90015-2536
(310) 770-7309
(213) 612-4936
Mailing address
120 N ELM DR, BEVERLY HILLS, CA 90210-5510
(310) 279-0624
(213) 612-4936
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
02/18/2009
Last updated
02/18/2009
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