Healthcare Provider Details

I. General information

NPI: 1851112247
Provider Name (Legal Business Name): PREFERRED MEDICAL SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2024
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18455 BURBANK BLVD STE 300
TARZANA CA
91356-6904
US

IV. Provider business mailing address

18455 BURBANK BLVD STE 300
TARZANA CA
91356-6904
US

V. Phone/Fax

Practice location:
  • Phone: 323-826-7177
  • Fax: 323-826-7122
Mailing address:
  • Phone: 323-826-7177
  • Fax: 323-826-7122

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: MS. MANDANA NAZAR
Title or Position: CEO
Credential:
Phone: 424-581-9232