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Organization

MEDICAL STORE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KENNETH ARTHUR KREINDEL (OWNER)
(949) 722-1128
Entity
Organization

Contact information

Practice address
333 E 17TH ST, SUITE 23, COSTA MESA, CA 92627-3220
(949) 722-1128
(949) 722-1315
Mailing address
333 E 17TH ST, SUITE 23, COSTA MESA, CA 92627-3220
(949) 722-1128
(949) 722-1315

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
102786
CA

Other

Enumeration date
11/13/2006
Last updated
06/27/2008
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