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NPI 1750200259

NPI 1750200259 : OSBORNE MEDICAL SUPPLY : PACOIMA, CA

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General NPI Number Information
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    NPI Number           |    1750200259
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    Entity Type          |    Organization 
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    Legal Business Name  |    OSBORNE MEDICAL SUPPLY 
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Dates
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    Enumeration Date     |    07/10/2026
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    Last Update Date     |    07/10/2026
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Provider Practice Location Address
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    Address Line         |    10750 GLENOAKS BLVD STE 8 
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    City                 |    PACOIMA
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    State                |    CA
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    Zip                  |    91331-7278
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    Country              |    US
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    Telephone            |    818-924-5450
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    Fax                  |    818-924-5452
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Provider Business Mailing Address
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    Address Line         |    10750 GLENOAKS BLVD STE 8 
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    City                 |    PACOIMA
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    State                |    CA
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    Zip                  |    91331-7278
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    Country              |    US
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    Telephone            |    818-924-5450
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    Fax                  |    818-924-5452
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     RUBEN  AVETISYAN 
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    Credential           |    
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    Telephone            |    818-966-2770
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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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