MEDICARE: E.C. MEDCARE EQUIPMENT & SUPPLIES

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	332BX2000X	Oxygen Equipment & Supplies (DME)	54942	CA

General Provider Information

NPI Number	:	1538424593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E.C. MEDCARE EQUIPMENT & SUPPLIES

Provider Business Mailing Address
First Line	:	3210 N SAN FERNANDO BLVD
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-2528
Country	:	US
Telephone Number	:	310-272-9998
Fax Number	:	818-302-2317

Provider Business Practice Location Address
First Line	:	3210 N SAN FERNANDO BLVD.
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-2061
Country	:	US
Telephone Number	:	310-272-9998
Fax Number	:	818-302-2317

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ENRIQUE PARAISO CABALLERO
Credential	:
Telephone Number	:	949-742-4279

Provider Enumeration Date	:	07/05/2012
Last Update Date	:	12/02/2015

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