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Organization

PROVECTA MEDICAL SUPPLY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
REZA JABARZADE (CEO)
(424) 281-8834
Entity
Organization

Contact information

Practice address
6333 WILSHIRE BLVD FL 1, LOS ANGELES, CA 90048-5702
(310) 861-3738
Mailing address
6333 WILSHIRE BLVD FL 1, LOS ANGELES, CA 90048-5702
(310) 861-3738

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
08/22/2023
Last updated
12/05/2023
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