Organization
CREATIVE WOMAN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BONNIE J KAUFMAN (PRESIDENT OF COMP)
(626) 358-6216
Entity
Organization
Contact information
Practice address
1530 S MYRTLE AV, CREATIVE WOMAN, MONROVIA, CA 91016
(626) 358-6216
(626) 358-7810
Mailing address
1530 S MYRTLE AV, MONROVIA, CA 91016
(626) 358-6216
(626) 358-7810
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ13472Z
BLUE SHIELD
CA
Enumeration date
09/07/2006
Last updated
08/22/2020
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