Healthcare Provider Details

I. General information

NPI: 1669565271
Provider Name (Legal Business Name): ALPINE OXYGEN HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 02/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2818 LA CIENEGA AVE. SUITE 305
LOS ANGELES CA
90034
US

IV. Provider business mailing address

2818 LA CIENEGA AVE. SUITE 305
LOS ANGELES CA
90034
US

V. Phone/Fax

Practice location:
  • Phone: 310-204-6444
  • Fax: 310-204-6440
Mailing address:
  • Phone: 310-204-6444
  • Fax: 310-204-6440

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. PHILIP RAHIMZADEH
Title or Position: OWNER
Credential:
Phone: 310-204-6444