Organization
CHARLES ETUK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E ETUK (DIRECTOR OF OPERATION)
(310) 241-0886
Entity
Organization
Contact information
Practice address
1011 S GAFFEY ST, SAN PEDRO, CA 90731-4033
(310) 241-0886
(310) 241-0876
Mailing address
1011 S GAFFEY ST, SAN PEDRO, CA 90731-4033
(310) 241-0886
(310) 241-0876
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
45847
CA
Other
Enumeration date
08/20/2006
Last updated
06/20/2008
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