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Organization

MIDWAY HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GENRIETA ALEXANDREA LANGE (OWNER/ MANAGING EMPLOYEE)
(310) 417-3536
Entity
Organization

Contact information

Practice address
8616 LA TIJERA BLVD STE 305, LOS ANGELES, CA 90045-3946
(310) 417-3536
Mailing address
8616 LA TIJERA BLVD STE 305, LOS ANGELES, CA 90045-3946
(310) 417-3536

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
44657
CA

Other

Enumeration date
07/18/2006
Last updated
08/22/2020
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