Organization
FUNDAMENTAL MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRIGORY ATKOZYAN (PRESIDENT)
(805) 230-2220
Entity
Organization
Contact information
Practice address
7114 RESEDA BLVD, RESEDA, CA 91335-4210
(805) 230-2220
(805) 230-2229
Mailing address
7114 RESEDA BLVD, RESEDA, CA 91335-4210
(805) 230-2220
(805) 230-2229
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
54837
CA
332BX2000X
Oxygen Equipment & Supplies (DME)
54837
CA
335E00000X
Prosthetic/Orthotic Supplier
Primary
54837
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598068512
—
CA
Enumeration date
12/14/2010
Last updated
04/17/2026
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