=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568757763
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADVANS CPAP INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2011
-----------------------------------------------------
Last Update Date | 06/15/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12881 KNOTT ST SUITE 203
-----------------------------------------------------
City | GARDEN GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92841-3925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-897-2727
-----------------------------------------------------
Fax | 267-295-8736
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12881 KNOTT ST SUITE 203
-----------------------------------------------------
City | GARDEN GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92841-3925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-897-2727
-----------------------------------------------------
Fax | 267-295-8736
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MR. LOUIS LE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 714-897-2727
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 103565
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------