Healthcare Provider Details

I. General information

NPI: 1689824740
Provider Name (Legal Business Name): BIOMATRIX, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2008
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5332 ZOLA AVE
PICO RIVERA CA
90660-2627
US

IV. Provider business mailing address

5332 ZOLA AVE
PICO RIVERA CA
90660-2627
US

V. Phone/Fax

Practice location:
  • Phone: 310-597-9163
  • Fax: 800-818-8391
Mailing address:
  • Phone: 310-597-9163
  • Fax: 800-818-8391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. JONATHAN GARCIA
Title or Position: PRES
Credential:
Phone: 310-464-1902