Healthcare Provider Details

I. General information

NPI: 1184377533
Provider Name (Legal Business Name): MAP MEDICAL SUPPLIES IMC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2022
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17507 CHATSWORTH ST
GRANADA HILLS CA
91344-5720
US

IV. Provider business mailing address

17507 CHATSWORTH ST
GRANADA HILLS CA
91344-5720
US

V. Phone/Fax

Practice location:
  • Phone: 818-832-4177
  • Fax: 818-832-4178
Mailing address:
  • Phone: 818-832-4177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. SIMON BRUCE SANDLER
Title or Position: CEO/PRESIDENT
Credential:
Phone: 818-832-4177