| NPI | 1083733042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERT CHOOMNGERN Manager 562-468-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CA 200522310202) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2008-06-18 |