MEDICARE: GLOBAL MEDICAL NETWORK, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	2806725	CA

General Provider Information

NPI Number	:	1114113347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOBAL MEDICAL NETWORK, INC

Provider Business Mailing Address
First Line	:	4470 W SUNSET BLVD
Second Line	:	STE 374
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6302
Country	:	US
Telephone Number	:	213-613-1137
Fax Number	:	213-617-8292

Provider Business Practice Location Address
First Line	:	4470 W SUNSET BLVD
Second Line	:	STE 374
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6302
Country	:	US
Telephone Number	:	213-613-1137
Fax Number	:	213-617-8292

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MS. ODARO OMOLARA OWEN
Credential	:	RN, MSN
Telephone Number	:	213-613-1137

Provider Enumeration Date	:	09/21/2007
Last Update Date	:	09/21/2007

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