Organization
IDA MED MEDICAL EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEHDI ABHARI (BUSINESS OWNER)
(714) 894-1818
Entity
Organization
Contact information
Practice address
12792 VALLEY VIEW ST, STE C, GARDEN GROVE, CA 92845-2509
(714) 894-1818
(714) 894-3121
Mailing address
12792 VALLEY VIEW ST, STE C, GARDEN GROVE, CA 92845
(714) 894-1818
(714) 894-3121
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
100642
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4204220001
MEDICARE ID PROVIDER NUMBER
CA
05
—
DME03026F
—
CA
Enumeration date
09/02/2005
Last updated
06/27/2008
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