Organization
MOTHER MANETEU MEDICAL SUPPLIES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH NOUBOUDEM DONGMO (PRESIDENT)
(818) 364-5581
Entity
Organization
Contact information
Practice address
12601 SAN FERNANDO RD, SUITE F, SYLMAR, CA 91342-7733
(818) 364-5581
(818) 364-5582
Mailing address
12601 SAN FERNANDO RD, SUITE F, SYLMAR, CA 91342-7733
(818) 364-5581
(818) 364-5582
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
103785
CA
Other
Enumeration date
07/13/2006
Last updated
11/01/2007
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