MEDICARE: CASPIAN MEDICAL SUPPLY HEALTH CARE

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	:	1689409575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASPIAN MEDICAL SUPPLY HEALTH CARE

Provider Business Mailing Address
First Line	:	20335 VENTURA BLVD STE 105
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2463
Country	:	US
Telephone Number	:	747-230-4217
Fax Number	:	747-230-4189

Provider Business Practice Location Address
First Line	:	20335 VENTURA BLVD STE 105
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2463
Country	:	US
Telephone Number	:	747-230-4217
Fax Number	:	747-230-4189

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SIYAVASH ZIAE
Credential	:
Telephone Number	:	747-323-7378

Provider Enumeration Date	:	09/03/2024
Last Update Date	:	09/03/2024

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