Healthcare Provider Details

I. General information

NPI: 1609680321
Provider Name (Legal Business Name): PB RELIEF DME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 WILSHIRE BLVD # 900-1073
LOS ANGELES CA
90017-2928
US

IV. Provider business mailing address

611 WILSHIRE BLVD # 900-1073
LOS ANGELES CA
90017-2928
US

V. Phone/Fax

Practice location:
  • Phone: 213-263-1687
  • Fax:
Mailing address:
  • Phone: 213-263-1687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MD FAYSAL AHMED
Title or Position: CEO
Credential:
Phone: 213-263-1687