MEDICARE: UC MEDICAL SUPPLY

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255482758
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UC MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	3535 CAHUENGA BLVD W STE 203
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-1359
Country	:	US
Telephone Number	:	323-876-3407
Fax Number	:	323-876-3629

Provider Business Practice Location Address
First Line	:	3535 CAHUENGA BLVD W STE 203
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-1359
Country	:	US
Telephone Number	:	323-876-3407
Fax Number	:	323-876-3629

Authorized Official
Title or Position	:	OWNER
Name	:	MR. NORAIR G BEZIKIAN
Credential	:
Telephone Number	:	323-876-3407

Provider Enumeration Date	:	01/13/2007
Last Update Date	:	08/22/2020

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Directions to “UC MEDICAL SUPPLY ” Practice Location

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