Provider Demographics
NPI:1992095988
Name:WEST COAST MEDICAL EQUIPMENT & REPAIR INC
Entity type:Organization
Organization Name:WEST COAST MEDICAL EQUIPMENT & REPAIR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:S
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-837-4330
Mailing Address - Street 1:9729 LURLINE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-4404
Mailing Address - Country:US
Mailing Address - Phone:818-837-4330
Mailing Address - Fax:818-837-4331
Practice Address - Street 1:9729 LURLINE AVE
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-4404
Practice Address - Country:US
Practice Address - Phone:818-837-4330
Practice Address - Fax:818-837-4331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55507332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6523940001Medicare NSC