Healthcare Provider Details

I. General information

NPI: 1053412049
Provider Name (Legal Business Name): INTERACTIVE MEDICAL SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11105 KNOTT AVE STE A
CYPRESS CA
90630-5137
US

IV. Provider business mailing address

11105 KNOTT AVE STE A
CYPRESS CA
90630-5137
US

V. Phone/Fax

Practice location:
  • Phone: 714-894-5029
  • Fax: 310-227-8229
Mailing address:
  • Phone: 714-894-5029
  • Fax: 310-227-8229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. LYNETTE POWELL
Title or Position: MANAGER
Credential:
Phone: 714-894-5029