Healthcare Provider Details

I. General information

NPI: 1275494072
Provider Name (Legal Business Name): PETE DME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 CENTER DR. 10TH FLOOR, SUITE # 34
LOS ANGELES CA
90045
US

IV. Provider business mailing address

PO BOX 1295
VENICE CA
90294-1295
US

V. Phone/Fax

Practice location:
  • Phone: 888-859-0029
  • Fax: 888-858-4179
Mailing address:
  • Phone: 888-859-0029
  • Fax: 888-858-4179

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: GERALD PARKS
Title or Position: CEO
Credential:
Phone: 888-859-0145