Organization
BLUE SPARROW CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BAPI MOHANTY (PRESIDENT)
(714) 772-1203
Entity
Organization
Contact information
Practice address
1515 S SUNKIST ST, SUITE G, ANAHEIM, CA 92806-5808
(714) 627-0100
Mailing address
1515 S SUNKIST ST, SUITE G, ANAHEIM, CA 92806-5808
(714) 627-0100
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
49618
CA
Other
Enumeration date
04/14/2009
Last updated
04/14/2009
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