=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245258847
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CURE ALL MEDICAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2006
-----------------------------------------------------
Last Update Date | 05/16/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5810 MONTEREY RD
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90042-4926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-344-8836
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 39497
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90039-0497
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-344-8836
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | MR. ANTONIO OBRIQUE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 323-244-8836
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number | 101716
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------