MEDICARE: MIKAEL OVSEPIAN

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	:	1659307098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIKAEL OVSEPIAN

Provider Business Mailing Address
First Line	:	1116 COLORADO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-2504
Country	:	US
Telephone Number	:	323-340-8955
Fax Number	:	323-340-1559

Provider Business Practice Location Address
First Line	:	1116 COLORADO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-2504
Country	:	US
Telephone Number	:	323-340-8955
Fax Number	:	323-340-1559

Authorized Official
Title or Position	:	OWNER
Name	:	MIKAEL OVSEPIAN
Credential	:
Telephone Number	:	323-340-8955

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	08/22/2020

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