# CLARENCE M. HYSHAW/MID-CITY ORTHO & NEURO SUPPLY

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

## Provider details

- **NPI number:** 1477669042
- **Authorized official:** MR. KENON D MCKINNEY (MANAGER)
- **Authorized official phone:** (310) 669-9806

## Contact information

- **Practice address:** 3622 MARTIN LUTHER KING JR BLVD, SUITE A, LYNWOOD, CA 90262-2607
- **Practice address phone:** (310) 669-9806
- **Practice address fax:** (310) 669-9804
- **Mailing address:** 3622 MARTIN LUTHER KING JR BLVD, SUITE A, LYNWOOD, CA 90262-2607
- **Mailing address phone:** (310) 669-9806
- **Mailing address fax:** (310) 669-9804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 2531 | CA | Yes |

## Other

- **Enumeration date:** 08/23/2006
- **Last updated:** 07/07/2008