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General NPI Number Information
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NPI Number | 1487725016
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Entity Type | Organization
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Legal Business Name | PITAL MEDICAL, INC.
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 333 S GRAND AVE STE 3310
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City | LOS ANGELES
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State | CA
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Zip | 90071-1538
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Country | US
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Telephone | 866-904-4171
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Fax | 866-724-3130
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Provider Business Mailing Address
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Address Line | 333 S GRAND AVE STE 3310
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City | LOS ANGELES
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State | CA
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Zip | 90071-1538
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Country | US
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Telephone | 866-904-4171
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Fax | 866-724-3130
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Authorized Official
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Title or Position | CEO
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Name | MS. ROLANDA TERICA BREAUX
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Credential | COP,CMF
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Telephone | 866-904-4171
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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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