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General NPI Number Information
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NPI Number | 1750569273
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Entity Type | Organization
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Legal Business Name | UNIQUE MEDICAL DISTRIBUTORS, INC.
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 06/08/2010
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Provider Practice Location Address
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Address Line | 10962 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90064-2115
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Country | US
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Telephone | 310-475-8983
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Fax | 310-475-8130
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Provider Business Mailing Address
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Address Line | 10962 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90064-2115
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Country | US
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Telephone | 310-475-8983
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Fax | 310-475-8130
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARYAM SEYEDAN
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Credential |
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Telephone | 310-475-8983
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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 | 48760
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 48760
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License Number State | CA
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