=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285022558
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NATIONAL SEATING AND MOBILITY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2015
-----------------------------------------------------
Last Update Date | 01/08/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1125 E STANFORD CT
-----------------------------------------------------
City | ANAHEIM
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92805-6822
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-939-9322
-----------------------------------------------------
Fax | 714-939-9323
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1125 E STANFORD CT
-----------------------------------------------------
City | ANAHEIM
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92805-6822
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-939-9322
-----------------------------------------------------
Fax | 714-939-9323
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | GENERAL MANAGER
-----------------------------------------------------
Name | MRS. TISH WORDEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 714-939-9322
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 621400785
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------