Organization
SOUTH BAY MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GABRIEL C EJIZU (OWNER)
(310) 522-4200
Entity
Organization
Contact information
Practice address
735 BROAD AVE, WILMINGTON, CA 90744-5833
(310) 522-4200
(310) 522-4244
Mailing address
PO BOX 663, WILMINGTON, CA 90748-0663
(310) 522-4200
(310) 522-4244
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
46263
CA
Other
Enumeration date
01/11/2007
Last updated
01/09/2008
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