Healthcare Provider Details

I. General information

NPI: 1619906690
Provider Name (Legal Business Name): ACI SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 06/25/2020
Certification Date: 06/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16108 HART ST
VANS NUYS CA
91406-3903
US

IV. Provider business mailing address

16108 HART ST
VANS NUYS CA
91406-3903
US

V. Phone/Fax

Practice location:
  • Phone: 818-508-1728
  • Fax: 818-508-1726
Mailing address:
  • Phone: 818-508-1728
  • Fax: 818-508-1726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number102800
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number102800
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number16166
License Number StateCA

VIII. Authorized Official

Name: AKHTAR GOLBAHAR
Title or Position: PRESIDENT
Credential:
Phone: 818-508-1726