Organization
NISSIM INSTITUTIONAL PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HOWARD WEISS (OWNER)
(818) 892-4555
Entity
Organization
Contact information
Practice address
9612 VAN NUYS BLVD, #108, PANORAMA CITY, CA 91402-1044
(909) 447-7040
(909) 447-7030
Mailing address
2701 KIMBALL AVE, POMONA, CA 91767-2268
(909) 447-7040
(909) 447-7030
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME01561F
—
CA
Enumeration date
05/09/2006
Last updated
01/06/2009
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