MEDICARE: HASSIM MEDICAL EQUIPMENT & SUPPLIES, 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	DHS PENDING	CA

General Provider Information

NPI Number	:	1962782771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HASSIM MEDICAL EQUIPMENT & SUPPLIES, INC.

Provider Business Mailing Address
First Line	:	8945 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-3549
Country	:	US
Telephone Number	:	323-750-1121
Fax Number	:	323-750-1122

Provider Business Practice Location Address
First Line	:	8945 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-3549
Country	:	US
Telephone Number	:	323-750-1121
Fax Number	:	323-750-1122

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. MARVIN HASSELL
Credential	:
Telephone Number	:	323-750-1121

Provider Enumeration Date	:	08/24/2011
Last Update Date	:	08/24/2011

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