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General NPI Number Information
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NPI Number | 1114113347
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Entity Type | Organization
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Legal Business Name | GLOBAL MEDICAL NETWORK, INC
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 4470 W SUNSET BLVD STE 374
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City | LOS ANGELES
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State | CA
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Zip | 90027-6302
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Country | US
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Telephone | 213-613-1137
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Fax | 213-617-8292
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Provider Business Mailing Address
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Address Line | 4470 W SUNSET BLVD STE 374
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City | LOS ANGELES
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State | CA
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Zip | 90027-6302
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Country | US
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Telephone | 213-613-1137
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Fax | 213-617-8292
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. ODARO OMOLARA OWEN
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Credential | RN, MSN
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Telephone | 213-613-1137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 2806725
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License Number State | CA
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