Organization
GALLANT MEDICAL SUPPLY INC
Active
Other names
GALLANT MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YOUNG DENNIS AHN (PRESIDENT/C.E.O)
(951) 672-4965
Entity
Organization
Contact information
Practice address
27740 ENCANTO DR, SUN CITY, CA 92586-4521
(951) 672-4965
(951) 672-4966
Mailing address
27740 ENCANTO DR, SUN CITY, CA 92586-4521
(951) 672-4965
(951) 672-4966
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
45661
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01193G
—
CA
Enumeration date
07/01/2006
Last updated
08/22/2020
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