MEDICARE: MAZSA CORPORATION

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	46250	CA

General Provider Information

NPI Number	:	1366501322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAZSA CORPORATION

Provider Business Mailing Address
First Line	:	1818 S WESTERN AVE
Second Line	:	SUITE 502
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-5807
Country	:	US
Telephone Number	:	323-373-9868
Fax Number	:	323-954-7424

Provider Business Practice Location Address
First Line	:	1818 S WESTERN AVE
Second Line	:	SUITE 502
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-5807
Country	:	US
Telephone Number	:	323-373-9868
Fax Number	:	323-954-7424

Authorized Official
Title or Position	:	DIRECTOR OF OPERATION
Name	:	MR. MOHAMMED OLATUNDE SHEKONI
Credential	:
Telephone Number	:	323-373-9868

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	10/26/2007

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Directions to “MAZSA CORPORATION ” Practice Location

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