Organization
GOLDEN LIFE MEDICAL DISTRIBUTORS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUEL NGOKA (MANAGER)
(310) 219-1612
Entity
Organization
Contact information
Practice address
11502 HAWTHORNE BLVD, SUITE A, HAWTHORNE, CA 90250-2314
(310) 219-1612
(310) 219-1864
Mailing address
11502 HAWTHORNE BLVD, SUITE A, HAWTHORNE, CA 90250-2314
(310) 219-1612
(310) 219-1864
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
46986
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46986
HMDR
CA
Enumeration date
02/01/2008
Last updated
04/29/2008
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