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General NPI Number Information
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NPI Number | 1497989776
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Entity Type | Organization
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Legal Business Name | GIMAG CORP
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Dates
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Enumeration Date | 05/14/2009
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Last Update Date | 02/22/2011
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Provider Practice Location Address
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Address Line | 4175 FIRST ST
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City | LIVERMORE
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State | CA
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Zip | 94551-4913
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Country | US
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Telephone | 925-273-7700
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Fax | 925-273-7802
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Provider Business Mailing Address
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Address Line | 4175 FIRST ST
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City | LIVERMORE
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State | CA
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Zip | 94551-4913
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Country | US
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Telephone | 925-273-7700
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Fax | 925-273-7802
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. OLUBUSAYO PHILLIP EKUNBOYEJO
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Credential |
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Telephone | 925-273-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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