MEDICARE: DURABLE MEDICAL EQUIPMENT OF CALIFORNIA

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	:	1972981546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DURABLE MEDICAL EQUIPMENT OF CALIFORNIA

Provider Business Mailing Address
First Line	:	959 S MULLEN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-1829
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	959 S MULLEN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-1829
Country	:	US
Telephone Number	:	310-431-5714
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. DAMON SORAYA
Credential	:	D.C
Telephone Number	:	310-431-5714

Provider Enumeration Date	:	05/14/2015
Last Update Date	:	05/14/2015

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