Medtech Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

49380 Issued in CA

Legal business name

MEDTECH MEDICAL SUPPLY

Practice address

1331 W Garvey Ave N
West Covina, CA 91790-2242

Phone

(626) 962-7580

Fax

(626) 960-1659

NPI assigned

Apr 18, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Olawale Ayoola Oyetibo

Title

Officer

Phone

(626) 962-7580

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1073578514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2098",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917692098",
            "telephone_number": "909-948-5895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 W GARVEY AVE N",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902242",
            "telephone_number": "626-962-7580",
            "fax_number": "626-960-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDTECH MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "OYETIBO",
        "authorized_official_first_name": "OLAWALE",
        "authorized_official_middle_name": "AYOOLA",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "626-962-7580",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "49380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL-CROSSOVER",
            "identifier": "DME03096F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janine Medina
• Maria Medina, RN
• Monique Medina
• Medquest Hospice Care
• Stephanie Priscilla Medrano
• Medtech Medical Supply, LLC
• Medwin a Professional Corporation
• Medwin Hospitalist and Healthcare Network
• Emily Mejia Campos
• Evelyn Mejia, SURGICAL TECH

• Durable Medical Equipment & Medical Supplies in West Covina, CA
• Providers in West Covina, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.