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General NPI Number Information
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NPI Number | 1265625081
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Entity Type | Organization
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Legal Business Name | SEBOL MEDICAL SUPPLIES
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 318 E HILLCREST BLVD STE 2
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City | INGLEWOOD
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State | CA
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Zip | 90301-2406
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Country | US
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Telephone | 310-419-3061
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Fax | 310-419-3062
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Provider Business Mailing Address
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Address Line | 318 E HILLCREST BLVD STE 2
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City | INGLEWOOD
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State | CA
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Zip | 90301-2406
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Country | US
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Telephone | 310-419-3061
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Fax | 310-419-3062
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MR. OLATUNBOSUN ABIODUN OSHUNLUYI
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Credential |
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Telephone | 310-419-3061
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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 | CA
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