Organization
EXPRESS MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELVIN JOCSON MESA (ADMINISTRATOR)
(619) 423-2600
Entity
Organization
Contact information
Practice address
639 MARSAT COURT, SUITE B, CHULA VISTA, CA 91911-4678
(619) 423-2600
Mailing address
639 MARSAT COURT, SUITE B, CHULA VISTA, CA 91911-4678
(619) 423-2600
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
53793
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912210204
—
CA
Enumeration date
05/25/2011
Last updated
05/25/2011
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