MEDICARE: DRAKE MEDICAL EQUIPMENT SERVICES, 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	332B00000X	Durable Medical Equipment & Medical Supplies	0000225966-0001-1	CA

General Provider Information

NPI Number	:	1134424195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRAKE MEDICAL EQUIPMENT SERVICES, INC.

Provider Business Mailing Address
First Line	:	1930 WILSHIRE BLVD., SUITE 902
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057
Country	:	US
Telephone Number	:	213-989-0858
Fax Number	:

Provider Business Practice Location Address
First Line	:	1930 WILSHIRE BLVD STE 902
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-3619
Country	:	US
Telephone Number	:	213-989-0858
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. GRACE LUNA
Credential	:
Telephone Number	:	213-989-0858

Provider Enumeration Date	:	01/21/2011
Last Update Date	:	01/21/2011

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