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General NPI Number Information
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NPI Number | 1447408620
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Entity Type | Organization
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Legal Business Name | DURU MEDICAL SUPPLIES, INC.
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Dates
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Enumeration Date | 08/30/2008
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Last Update Date | 05/05/2010
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Provider Practice Location Address
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Address Line | 1704 W MANCHESTER AVE SUITE 207E
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City | LOS ANGELES
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State | CA
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Zip | 90047-3077
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Country | US
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Telephone | 323-789-6100
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Fax | 323-759-0440
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Provider Business Mailing Address
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Address Line | 1704 W MANCHESTER AVE SUITE 207E
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City | LOS ANGELES
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State | CA
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Zip | 90047-3077
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Country | US
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Telephone | 323-789-6100
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Fax | 323-759-0440
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | IYKE DURU
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Credential |
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Telephone | 323-789-6100
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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 | 50332
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License Number State | CA
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