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General NPI Number Information
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NPI Number | 1023410412
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Entity Type | Organization
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Legal Business Name | LADB MEDICAL SUPPLIES, LLC.
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 1854 COLBY AVE APT 1
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City | LOS ANGELES
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State | CA
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Zip | 90025-5420
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Country | US
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Telephone | 310-347-2752
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Fax |
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Provider Business Mailing Address
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Address Line | 1854 COLBY AVE APT 1
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City | LOS ANGELES
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State | CA
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Zip | 90025-5420
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Country | US
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Telephone | 310-347-2752
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ANTHONY DAVID BAMONTE
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Credential |
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Telephone | 310-347-2752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1083937122
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License Number State | OH
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