MEDICARE: MICRO MEDICAL MANAGEMENT

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	:	1598041782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICRO MEDICAL MANAGEMENT

Provider Business Mailing Address
First Line	:	13896 HARBOR BLVD
Second Line	:	SUITE 5-C
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-4045
Country	:	US
Telephone Number	:	714-554-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	13896 HARBOR BLVD
Second Line	:	SUITE 5-C
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-4045
Country	:	US
Telephone Number	:	714-554-2222
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SIROUS SORAT
Credential	:
Telephone Number	:	714-554-2222

Provider Enumeration Date	:	11/01/2011
Last Update Date	:	11/01/2011

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Directions to “MICRO MEDICAL MANAGEMENT ” Practice Location

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