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General NPI Number Information
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NPI Number | 1134647670
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Entity Type | Organization
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Legal Business Name | GOLD MEDICAL SUPPLIES INC.
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Dates
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Enumeration Date | 09/05/2017
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Last Update Date | 09/05/2017
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Provider Practice Location Address
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Address Line | 1450 2ND ST
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City | SANTA MONICA
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State | CA
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Zip | 90401-2302
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Country | US
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Telephone | 424-465-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 1223 WILSHIRE BLVD # 980
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City | SANTA MONICA
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State | CA
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Zip | 90403-5406
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGIONAL DIRECTOR
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Name | THEODORE SEMENIUTA
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Credential | JD, LLM
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Telephone | 424-465-3700
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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 |
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License Number State |
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