# AVETIS AVETISYAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** A&T Medical Supply
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114077328
- **Authorized official:** MR. AVETIS AVETISYAN (OWNER)
- **Authorized official phone:** (650) 872-7002

## Contact information

- **Practice address:** 1133 EL CAMINO REAL STE 7, SOUTH SAN FRANCISCO, CA 94080-3288
- **Practice address phone:** (650) 872-7002
- **Practice address fax:** (650) 872-0441
- **Mailing address:** 1133 EL CAMINO REAL, SUITE 7, SOUTH SAN FRANCISCO, CA 94080-3288
- **Mailing address phone:** (650) 872-7002
- **Mailing address fax:** (650) 872-0441

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 102525 | CA | Yes |

## Other

- **Enumeration date:** 01/11/2007
- **Last updated:** 02/05/2009