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General NPI Number Information
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NPI Number | 1932135258
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Entity Type | Organization
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Legal Business Name | CANAAN MEDICAL SUPPLY, INC.
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 903 S CRENSHAW BLVD SUITE 102A
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City | LOS ANGELES
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State | CA
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Zip | 90019-1964
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Country | US
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Telephone | 323-935-4000
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Fax | 323-937-8970
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Provider Business Mailing Address
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Address Line | 903 S CRENSHAW BLVD SUITE 102A
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City | LOS ANGELES
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State | CA
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Zip | 90019-1964
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Country | US
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Telephone | 323-935-4000
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Fax | 323-937-8970
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Authorized Official
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Title or Position | PRESIDENT
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Name | BOK HEE CHA
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Credential |
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Telephone | 323-935-4000
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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 | 6057490002
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License Number State | CA
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