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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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