Organization
MAPLE MEDICAL SUPPLY INC
Active
Other names
Maple Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEO SUNGLIN WANG (CEO/PRESIDENT)
(559) 469-3686
Entity
Organization
Contact information
Practice address
228 N L ST, DINUBA, CA 93618-2106
(559) 591-6008
Mailing address
228 N L ST, DINUBA, CA 93618-2106
(559) 591-6008
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
103613
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME03225F
—
CA
01
—
ZZZ66519Z
BLUE SHEILD
CA
Enumeration date
08/23/2006
Last updated
07/21/2022
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