Organization
CALIFORNIA JUCO HOOPS REPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCUS LEE BRYANT (MANAGER)
(657) 427-3895
Entity
Organization
Contact information
Practice address
4526 CALIFORNIA AVE, LONG BEACH, CA 90807-1589
(657) 427-3895
Mailing address
5090 RICHMOND AVE UNIT 315, HOUSTON, TX 77056-7402
(657) 427-3895
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/22/2025
Last updated
03/25/2026
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