MEDICARE: OCB MEDICAL EQUIPMENT AND SUPPLY

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	332BX2000X	Oxygen Equipment & Supplies (DME)	103408	CA

General Provider Information

NPI Number	:	1184837957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCB MEDICAL EQUIPMENT AND SUPPLY

Provider Business Mailing Address
First Line	:	3560 S LA CIENEGA BLVD
Second Line	:	SUITE D
City	:	LOS ANGELES
State	:	CA
Zip	:	90016-4400
Country	:	US
Telephone Number	:	323-954-8296
Fax Number	:	323-954-8297

Provider Business Practice Location Address
First Line	:	3560 S LA CIENEGA BLVD
Second Line	:	SUITE D
City	:	LOS ANGELES
State	:	CA
Zip	:	90016-4400
Country	:	US
Telephone Number	:	323-954-8296
Fax Number	:	323-954-8297

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CLEMENT AWAJI
Credential	:
Telephone Number	:	323-954-8296

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	07/08/2008

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