Organization
MILLBRAE MEDICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLIVER W FRIEDAUER (PRESIDENT)
(650) 593-2188
Entity
Organization
Contact information
Practice address
425 OLD COUNTY RD STE C, BELMONT, CA 94002-2500
(650) 593-2188
(650) 593-2044
Mailing address
425 OLD COUNTY RD STE C, BELMONT, CA 94002-2500
(650) 593-2188
(650) 593-2044
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
DME00543F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DME00543F
MEDI-CAL PROVIDER
CA
Enumeration date
10/26/2005
Last updated
11/19/2013
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