Organization
SEA BREEZE MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFONSO PALACIOS (OWNER)
(310) 944-3200
Entity
Organization
Contact information
Practice address
1926 S PACIFIC COAST HWY STE 112, REDONDO BEACH, CA 90277-6149
(310) 944-3200
(310) 944-3208
Mailing address
1926 S PACIFIC COAST HWY STE 112, REDONDO BEACH, CA 90277-6149
(310) 944-3200
(310) 944-3208
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
103115
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME03268F
—
CA
Enumeration date
01/02/2007
Last updated
08/22/2020
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