Healthcare Provider Details

I. General information

NPI: 1376572016
Provider Name (Legal Business Name): A&K MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 01/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13735 VICTORY BLVB #7
VAN NUYS CA
91401-2300
US

IV. Provider business mailing address

13735 VICTORY BLVB #7
VAN NUYS CA
91401-2300
US

V. Phone/Fax

Practice location:
  • Phone: 818-904-2645
  • Fax: 818-904-2745
Mailing address:
  • Phone: 818-904-2645
  • Fax: 818-904-2745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number715231-80
License Number StateCA

VIII. Authorized Official

Name: MR. KAHREN BOKSIAN
Title or Position: OWNER
Credential:
Phone: 818-904-2645