MEDICARE: PHYSICIANS CHOICE MEDICAL, INC

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	:	1780810564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS CHOICE MEDICAL, INC

Provider Business Mailing Address
First Line	:	1627 S CENTRAL AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-2734
Country	:	US
Telephone Number	:	805-409-0600
Fax Number	:	805-497-0905

Provider Business Practice Location Address
First Line	:	1627 S CENTRAL AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-2734
Country	:	US
Telephone Number	:	805-409-0600
Fax Number	:	805-497-0905

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. REBECCA DAY
Credential	:
Telephone Number	:	805-409-0600

Provider Enumeration Date	:	06/07/2009
Last Update Date	:	07/27/2022

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