Healthcare Provider Details

I. General information

NPI: 1154487197
Provider Name (Legal Business Name): COMFORT MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 MYRLEWOOD DR
CALIMESA CA
92320
US

IV. Provider business mailing address

542 MYRLEWOOD DR
CALIMESA CA
92320
US

V. Phone/Fax

Practice location:
  • Phone: 909-795-6615
  • Fax: 909-795-6607
Mailing address:
  • Phone: 909-795-6615
  • Fax: 909-795-6607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number103641
License Number StateCA

VIII. Authorized Official

Name: ABDUL HUSSAIN
Title or Position: PRESIDENT
Credential:
Phone: 909-795-6615