Organization
DANIEL CHUKWU
Active
Other names
THE ANGEL MEDICAL DISTRIBUTOR
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL CHUKWU (OWNER)
(310) 675-4666
Entity
Organization
Contact information
Practice address
14023 CRENSHAW BLVD, SUITE 4, HAWTHORNE, CA 90250-9255
(310) 675-4666
(310) 675-4004
Mailing address
14023 CRENSHAW BLVD, SUITE 4, HAWTHORNE, CA 90250-9255
(310) 675-4666
(310) 675-4004
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
102873
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4809150001
MEDICARE PROVIDER NUMBER
CA
Enumeration date
03/17/2008
Last updated
09/11/2008
Update your record
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