Organization
VITAL MEDICAL SUPPLY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE GAVIOLA (PRESIDENT)
(323) 550-8888
Entity
Organization
Contact information
Practice address
4515 EAGLE ROCK BLVD, SUITE 145C, LOS ANGELES, CA 90041-3214
(323) 550-8888
(323) 550-8881
Mailing address
4515 EAGLE ROCK BLVD., SUITE 145C, LOS ANGELES, CA 90041-3214
(323) 550-8888
(323) 550-8881
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
002197618
CA
Other
Enumeration date
07/14/2009
Last updated
07/14/2009
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