Organization
WESTLAKE MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMELIA LOUISE RAILA LE (OWNER, LACTATION EDUCATOR)
(818) 512-6824
Entity
Organization
Contact information
Practice address
1228 S WESTLAKE BLVD UNIT D, WESTLAKE VILLAGE, CA 91361-1940
(818) 512-6824
Mailing address
1228 S WESTLAKE BLVD UNIT D, WESTLAKE VILLAGE, CA 91361-1940
(818) 512-6824
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
PENDING
CA
Other
Enumeration date
11/08/2007
Last updated
11/08/2007
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