Organization
MIRACLE MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY ABABSEH (SOLE MEMBER)
(805) 432-0072
Entity
Organization
Contact information
Practice address
2025 SUEDE ST, SIMI VALLEY, CA 93063-4012
(805) 432-0072
Mailing address
2025 SUEDE ST, SIMI VALLEY, CA 93063-4012
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
06/14/2010
Last updated
06/14/2010
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