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General NPI Number Information
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NPI Number | 1457086621
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Entity Type | Organization
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Legal Business Name | MASERTIO INC
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 2110 S LYON ST STE G
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City | SANTA ANA
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State | CA
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Zip | 92705-5320
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Country | US
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Telephone | 909-838-7984
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Fax |
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Provider Business Mailing Address
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Address Line | 12092 HENRY EVANS DR
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City | GARDEN GROVE
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State | CA
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Zip | 92840-3376
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Country | US
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Telephone | 909-838-7984
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TE LU
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Credential |
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Telephone | 909-838-7984
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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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