MEDICARE: HUNTINGTON BEACH MEDICAL 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	3592439	CA

General Provider Information

NPI Number	:	1881011708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNTINGTON BEACH MEDICAL INC

Provider Business Mailing Address
First Line	:	PO BOX 3119
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92605-3119
Country	:	US
Telephone Number	:	866-697-7167
Fax Number	:	714-766-7241

Provider Business Practice Location Address
First Line	:	5702 BOLSA AVE
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-1128
Country	:	US
Telephone Number	:	866-697-7167
Fax Number	:	714-766-7241

Authorized Official
Title or Position	:	CFO
Name	:	KIMBERLY ZINK
Credential	:
Telephone Number	:	714-500-4015

Provider Enumeration Date	:	03/28/2014
Last Update Date	:	03/28/2014

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