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General NPI Number Information
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NPI Number | 1083646202
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Entity Type | Organization
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Legal Business Name | YOLANDA DUARTE-WHITE PROVISION SUPPLIES
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 12221 HADLEY ST
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City | WHITTIER
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State | CA
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Zip | 90601-3914
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Country | US
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Telephone | 562-695-8115
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Fax | 562-695-8445
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Provider Business Mailing Address
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Address Line | 749 CLELA AVE
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City | LOS ANGELES
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State | CA
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Zip | 90022-3106
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Country | US
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Telephone | 626-826-3112
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Fax | 323-268-1485
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MS. YOLANDA DUARTE-WHITE
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Credential |
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Telephone | 562-695-8115
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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 | 103861
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License Number State | CA
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