MEDICARE: YESNACO HEALTH SERVICE

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

General Provider Information

NPI Number	:	1275522310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YESNACO HEALTH SERVICE

Provider Business Mailing Address
First Line	:	PO BOX 352257
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-0258
Country	:	US
Telephone Number	:	323-733-7338
Fax Number	:	323-733-7309

Provider Business Practice Location Address
First Line	:	4809 W ADAMS BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90016-2820
Country	:	US
Telephone Number	:	323-733-7338
Fax Number	:	323-733-7309

Authorized Official
Title or Position	:	CEO
Name	:	MR. NII AHUMA OCANSEY
Credential	:
Telephone Number	:	323-733-7338

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	07/24/2008

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