Healthcare Provider Details

I. General information

NPI: 1194822320
Provider Name (Legal Business Name): METRO-MED, INC. - LOS ALAMITOS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10841 NOEL ST STE. 108, 103
LOS ALAMITOS CA
90720-2597
US

IV. Provider business mailing address

8999 GEMINI PKWY STE 220
COLUMBUS OH
43240-2250
US

V. Phone/Fax

Practice location:
  • Phone: 714-761-9761
  • Fax: 714-761-8455
Mailing address:
  • Phone: 614-573-9075
  • Fax: 614-568-5290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number100347
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number100347
License Number StateCA

VIII. Authorized Official

Name: MR. JAMES YAEGER
Title or Position: PRESIDENT
Credential:
Phone: 818-840-9090