# MEDICALSTATIONSUPPLY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073752820
- **Authorized official:** DANIEL AZIZI (TREASURER)
- **Authorized official phone:** (310) 279-0642

## Contact information

- **Practice address:** 1143 S LOS ANGELES ST, LOS ANGELES, CA 90015-2536
- **Practice address phone:** (310) 770-7309
- **Practice address fax:** (213) 612-4936
- **Mailing address:** 120 N ELM DR, BEVERLY HILLS, CA 90210-5510
- **Mailing address phone:** (310) 279-0624
- **Mailing address fax:** (213) 612-4936

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 02/18/2009
- **Last updated:** 02/18/2009