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General NPI Number Information
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NPI Number | 1184803959
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Entity Type | Organization
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Legal Business Name | JOSHUA G ADEGBE
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 2149 E GARVEY AVE N STE A1
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City | WEST COVINA
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State | CA
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Zip | 91791-1508
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Country | US
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Telephone | 626-974-4221
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Fax | 626-339-6656
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Provider Business Mailing Address
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Address Line | 2149 E GARVEY AVE N STE A1
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City | WEST COVINA
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State | CA
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Zip | 91791-1508
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Country | US
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Telephone | 626-974-4221
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Fax | 626-339-6656
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. JOSHUA GUAGHE ADEGBE
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Credential |
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Telephone | 626-974-4221
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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 | 103182
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License Number State | CA
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