=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891710711
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAD AND ASSOCIATES INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2006
-----------------------------------------------------
Last Update Date | 08/21/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 335 W ARBOR VITAE ST STE.2
-----------------------------------------------------
City | INGLEWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90301-3767
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-419-1134
-----------------------------------------------------
Fax | 310-419-1130
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 335 W ARBOR VITAE ST STE.2
-----------------------------------------------------
City | INGLEWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90301-3767
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-419-1134
-----------------------------------------------------
Fax | 310-419-1130
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | MARIAM A SALAU
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 310-419-1134
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 103762
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------