| NPI | 1104835024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UKPONG EKANEM ITO Owner 310-406-3904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 433834) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2007-12-11 |