MEDICARE: NATIONWIDE MEDICAL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	45263	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ66262Z	OTHER	CA	BS OF CA PROVIDER #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073551446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONWIDE MEDICAL, INC.

Provider Business Mailing Address
First Line	:	5230 LAS VIRGENES RD STE 105
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-3447
Country	:	US
Telephone Number	:	818-338-3500
Fax Number	:	818-338-3501

Provider Business Practice Location Address
First Line	:	5230 LAS VIRGENES RD STE 105
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-3447
Country	:	US
Telephone Number	:	818-338-3500
Fax Number	:	818-338-3501

Authorized Official
Title or Position	:	CEO
Name	:	DAVID SIEGEL
Credential	:
Telephone Number	:	818-338-3502

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	03/09/2022

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