# KINGDOM MEDICAL SUPPLY INC

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

## Provider details

- **NPI number:** 1962555938
- **Authorized official:** MRS. CHRISTINE JIN ZHAO (PRESIDENT & CEO)
- **Authorized official phone:** (415) 751-0628

## Contact information

- **Practice address:** 1812 IRVING ST, SAN FRANCISCO, CA 94122-1818
- **Practice address phone:** (415) 751-0628
- **Practice address fax:** (415) 751-0619
- **Mailing address:** 1812 IRVING ST, SAN FRANCISCO, CA 94122-1818
- **Mailing address phone:** (415) 751-0628
- **Mailing address fax:** (415) 751-0619

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 46267 | CA | Yes |
| 332BC3200X | Customized Equipment (DME) | 46267 | CA | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | 46267 | CA | — |
| 335E00000X | Prosthetic/Orthotic Supplier | 46267 | CA | — |

## Other

- **Enumeration date:** 01/21/2007
- **Last updated:** 10/29/2025