Organization
WANNAPORN MULLAN
Active
Other names
Coalinga Medical Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WANNAPORN MULLAN (OWNER)
(559) 935-9350
Entity
Organization
Contact information
Practice address
155 SOUTH 5TH STREET, SUITE A, COALINGA, CA 93210-1903
(559) 935-9350
(559) 935-2329
Mailing address
155 SOUTH 5TH STREET, SUITE A, COALINGA, CA 93210-1903
(559) 935-9350
(559) 935-2329
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ06748Z
BLUE SHIELD
CA
Enumeration date
08/29/2006
Last updated
06/23/2008
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