| NPI | 1053707182 |
|---|---|
| Former Legal Business Name | GOLD COAST DIABETES |
| Entity Type | Organization |
| Authorized Contact | CARIE MORTENSEN CEO/President 562-706-4552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2015-04-24 |