# WICKED MEDICAL

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

## Provider details

- **NPI number:** 1144556390
- **Authorized official:** MR. JOEY TUSIA (PRESIDENT)
- **Authorized official phone:** (562) 843-2573

## Contact information

- **Practice address:** 5580 IMPERIAL HWY, SOUTH GATE, CA 90280-7418
- **Practice address phone:** (855) 850-5888
- **Mailing address:** 5580 IMPERIAL HWY, SOUTH GATE, CA 90280-7418

## Taxonomy

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

## Other

- **Enumeration date:** 10/22/2009
- **Last updated:** 07/23/2015