MEDICARE: PRINTER REPAIR & DIAGNOSTIC SUPPORT

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	:	1710824933
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRINTER REPAIR & DIAGNOSTIC SUPPORT

Provider Business Mailing Address
First Line	:	2880 HULEN PL
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92507-2606
Country	:	US
Telephone Number	:	951-556-3599
Fax Number	:

Provider Business Practice Location Address
First Line	:	2880 HULEN PL
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92507-2606
Country	:	US
Telephone Number	:	951-556-3599
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. CHRISTIAN OLA OJOMO JR.
Credential	:	DO
Telephone Number	:	951-556-3599

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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