Organization
NTIEDO JOHNSON INYANG
Active
Other names
Lifeline Medical Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NTIEDO JOHNSON INYANG (OWNER / CEO)
(510) 595-8474
Entity
Organization
Contact information
Practice address
3139 SAN PABLO AVE, OAKLAND, CA 94608-4533
(510) 595-8474
(510) 595-8410
Mailing address
3139 SAN PABLO AVE, OAKLAND, CA 94608-4533
(510) 595-8474
(510) 595-8410
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
103425
CA
Other
Enumeration date
07/28/2006
Last updated
07/14/2008
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