Healthcare Provider Details
I. General information
NPI: 1801991567
Provider Name (Legal Business Name): PICO MEDICAL RENTS & SELLS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6035 W PICO BLVD
LOS ANGELES CA
90035-2624
US
IV. Provider business mailing address
6035 W PICO BLVD
LOS ANGELES CA
90035-2624
US
V. Phone/Fax
- Phone: 323-936-4104
- Fax: 323-936-3454
- Phone: 323-936-4104
- Fax: 323-936-3454
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 1494 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | 1494 |
| License Number State | CA |
VIII. Authorized Official
Name: MRS.
PENNY
LYNN
RANGEL
Title or Position: PRESIDENT
Credential:
Phone: 323-936-4104