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General NPI Number Information
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NPI Number | 1477869741
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Entity Type | Organization
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Legal Business Name | STEVENSON INDUSTRIES, INC.
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 5142 N COMMERCE AVE STE D
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City | MOORPARK
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State | CA
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Zip | 93021-7134
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Country | US
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Telephone | 805-426-3544
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Fax | 805-426-3551
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Provider Business Mailing Address
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Address Line | 5142 N COMMERCE AVE STE D
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City | MOORPARK
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State | CA
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Zip | 93021-7134
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Country | US
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Telephone | 805-426-3544
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Fax | 805-426-3551
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Authorized Official
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Title or Position | CEO
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Name | MARK CHRISTIANSEN
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Credential |
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Telephone | 805-426-3544
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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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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 47489
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License Number State | CA
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