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General NPI Number Information
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NPI Number | 1093749277
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Entity Type | Organization
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Legal Business Name | MGS MEDICAL EQUIPMENT SUPPLIER
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 8921 S SEPULVEDA BLVD STE 104
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City | LOS ANGELES
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State | CA
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Zip | 90045-3650
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Country | US
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Telephone | 310-670-7439
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Fax | 310-670-7465
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Provider Business Mailing Address
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Address Line | 8921 S SEPULVEDA BLVD STE 104
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City | LOS ANGELES
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State | CA
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Zip | 90045-3650
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Country | US
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Telephone | 310-670-7439
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Fax | 310-670-7465
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Authorized Official
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Title or Position | PRISDENT
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Name | MR. GIRMAYE SEYUM
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Credential |
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Telephone | 310-670-7439
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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 | 000201429000012
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License Number State | CA
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