Organization
LTD MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ILYA MELLER (OWNER PROVIDER)
(310) 202-6511
Entity
Organization
Contact information
Practice address
4315 OVERLAND AVE, STE B, CULVER CITY, CA 90230-4128
(310) 202-6511
(310) 202-6027
Mailing address
4315 OVERLAND AVE, STE B, CULVER CITY, CA 90230-4128
(310) 202-6511
(310) 202-6027
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME02572F
—
CA
Enumeration date
09/13/2005
Last updated
09/11/2025
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