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General NPI Number Information
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NPI Number | 1356803027
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Entity Type | Organization
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Legal Business Name | WILSHIRE WIGS & ACCESSORIES INC.
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 04/02/2019
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Provider Practice Location Address
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Address Line | 5241 CRANER AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-3311
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Country | US
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Telephone | 818-635-5155
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Fax |
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Provider Business Mailing Address
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Address Line | 5241 CRANER AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-3311
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Country | US
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Telephone | 818-635-5155
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Fax |
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Authorized Official
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Title or Position | DIRECTOR O OPERATIONS
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Name | MISS CAROLINE NICOLE LOVELL-MOORE
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Credential |
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Telephone | 310-936-3785
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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 |
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