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General NPI Number Information
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NPI Number | 1588894919
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Entity Type | Organization
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Legal Business Name | OPTIMUM CARE MEDICAL INC
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 15120 ATKINSON AVE STE 6
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City | GARDENA
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State | CA
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Zip | 90249-4037
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Country | US
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Telephone | 310-217-9955
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Fax | 310-217-9988
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Provider Business Mailing Address
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Address Line | 15120 ATKINSON AVE STE 6
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City | GARDENA
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State | CA
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Zip | 90249-4037
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Country | US
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Telephone | 310-217-9955
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Fax | 310-217-9988
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHUKWUEMEKA NWODIKA
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Credential |
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Telephone | 310-217-9955
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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 | 52240
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License Number State | CA
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