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General NPI Number Information
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NPI Number | 1528298775
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Entity Type | Organization
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Legal Business Name | PROMED MEDICAL SUPPLIES
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Dates
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Enumeration Date | 07/22/2009
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 16200 VENTURA BLVD STE 101AB
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City | ENCINO
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State | CA
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Zip | 91436-2205
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Country | US
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Telephone | 310-836-6060
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Fax | 310-836-9090
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Provider Business Mailing Address
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Address Line | 16661 VENTURA BLVD STE 518
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City | ENCINO
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State | CA
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Zip | 91436-1924
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Country | US
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Telephone | 310-836-6060
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Fax | 310-836-9090
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHAWN YADIDI
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Credential |
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Telephone | 310-836-6060
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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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