MEDICARE: MARKNEW PRODUCTS CORP

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	4888350001	CA

General Provider Information

NPI Number	:	1245389162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARKNEW PRODUCTS CORP

Provider Business Mailing Address
First Line	:	14140 FIRESTONE BLVD
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-5810
Country	:	US
Telephone Number	:	562-404-2257
Fax Number	:

Provider Business Practice Location Address
First Line	:	14140 FIRESTONE BLVD
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-5810
Country	:	US
Telephone Number	:	562-404-2257
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TAE HYUN KIM
Credential	:
Telephone Number	:	562-404-2257

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	08/22/2020

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