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General NPI Number Information
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NPI Number | 1568446938
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Entity Type | Organization
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Legal Business Name | OAKLAND MEDICAL SUPPLY
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 823 HARRISON ST
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City | OAKLAND
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State | CA
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Zip | 94607-4422
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Country | US
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Telephone | 510-268-3228
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Fax | 510-268-3238
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Provider Business Mailing Address
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Address Line | 823 HARRISON ST
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City | OAKLAND
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State | CA
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Zip | 94607-4422
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Country | US
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Telephone | 510-268-3228
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Fax | 510-268-3238
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Authorized Official
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Title or Position | OWNER
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Name | MS. ANN FOK
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Credential |
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Telephone | 510-268-3228
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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 | 102486
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License Number State | CA
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