Organization
MEDICALSHOPPE.COM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILSON A MARTINEZ BSC, LLB (CEO)
(323) 340-3962
Entity
Organization
Contact information
Practice address
2501 COLORADO BLVD, SUITE H, LOS ANGELES, CA 90041-1055
(323) 340-3962
(323) 340-3963
Mailing address
2501 COLORADO BLVD, SUITE H, LOS ANGELES, CA 90041-1055
(323) 340-3962
(323) 340-3963
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
44021
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME03315F
—
CA
Enumeration date
05/26/2006
Last updated
08/22/2020
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