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General NPI Number Information
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NPI Number | 1184837957
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Entity Type | Organization
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Legal Business Name | OCB MEDICAL EQUIPMENT AND SUPPLY
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 3560 S LA CIENEGA BLVD SUITE D
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City | LOS ANGELES
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State | CA
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Zip | 90016-4400
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Country | US
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Telephone | 323-954-8296
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Fax | 323-954-8297
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Provider Business Mailing Address
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Address Line | 3560 S LA CIENEGA BLVD SUITE D
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City | LOS ANGELES
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State | CA
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Zip | 90016-4400
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Country | US
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Telephone | 323-954-8296
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Fax | 323-954-8297
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Authorized Official
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Title or Position | PRESIDENT
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Name | CLEMENT AWAJI
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Credential |
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Telephone | 323-954-8296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 103408
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License Number State | CA
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