Organization
MEDTECH MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLAWALE AYOOLA OYETIBO (OFFICER)
(626) 962-7580
Entity
Organization
Contact information
Practice address
1331 W GARVEY AVE N, WEST COVINA, CA 91790-2242
(626) 962-7580
(626) 960-1659
Mailing address
PO BOX 2098, POMONA, CA 91769-2098
(909) 948-5895
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
49380
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DME03096F
MEDICAL-CROSSOVER
CA
Enumeration date
04/18/2006
Last updated
02/05/2009
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