Organization
PACIFIC COAST MEDICAL SUPPLIES
Active
Other names
Gold Coast Diabetes Resource, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CARIE FRANCES MORTENSEN (CEO/PRESIDENT)
(562) 706-4552
Entity
Organization
Contact information
Practice address
1704 W. MANCHESTER AVE., SUITE 105, LOS ANGELES, CA 90047-3327
(562) 706-4552
(877) 733-3462
Mailing address
218 CHICAGO AVE, SUITE 8, HUNTINGTON BEACH, CA 92648
(562) 706-4552
(877) 733-3462
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
CA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
04/01/2009
Last updated
04/29/2015
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