| NPI | 1295976108 |
|---|---|
| Other Name | MAGIC MANGOSTEEN |
| Entity Type | Organization |
| Authorized Contact | RAY DU BOC ALI Director / President 323-375-9973 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2009-03-23 |