MEDICARE: MAGNORM HEALTHCARE 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

General Provider Information

NPI Number	:	1194756130
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAGNORM HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	24328 VERMONT AVE
Second Line	:	SUITE 245
City	:	HARBOR CITY
State	:	CA
Zip	:	90710-2314
Country	:	US
Telephone Number	:	310-539-5525
Fax Number	:	310-539-5529

Provider Business Practice Location Address
First Line	:	24328 VERMONT AVE
Second Line	:	SUITE 245
City	:	HARBOR CITY
State	:	CA
Zip	:	90710-2314
Country	:	US
Telephone Number	:	310-539-5525
Fax Number	:	310-539-5529

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. GONZALO MADRIGAL JR.
Credential	:
Telephone Number	:	310-539-5525

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	08/22/2020

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