Healthcare Provider Details

I. General information

NPI: 1538424593
Provider Name (Legal Business Name): E.C. MEDCARE EQUIPMENT & SUPPLIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 N SAN FERNANDO BLVD.
BURBANK CA
91504-2061
US

IV. Provider business mailing address

3210 N SAN FERNANDO BLVD
BURBANK CA
91504-2528
US

V. Phone/Fax

Practice location:
  • Phone: 310-272-9998
  • Fax: 818-302-2317
Mailing address:
  • Phone: 310-272-9998
  • Fax: 818-302-2317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number54942
License Number StateCA

VIII. Authorized Official

Name: MR. ENRIQUE PARAISO CABALLERO
Title or Position: OWNER
Credential:
Phone: 949-742-4279