Active NPI
Prohealth Medical Supply Inc
- Durable Medical Equipment & Medical Supplies
- Los Angeles, CA
National Provider Identifier
1104123652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 54295
- Legal business name
- PROHEALTH MEDICAL SUPPLY INC
- Practice address
- 4509 Eagle Rock Blvd
Ste B
Los Angeles, CA 90041-3214 - Phone
- (323) 255-3504
- Fax
- (323) 255-3504
- NPI assigned
- Feb 18, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Abdul R Wahab
- Title
- Ceo
- Phone
- (510) 329-7997
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 54295 | CA | Primary |
Addresses
Primary practice location
4509 Eagle Rock Blvd
Ste B
Los Angeles, CA 90041-3214
Mailing address
4625 First St
Suite B
Pleasanton, CA 94566
Phone (510) 329-7997
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Prohealth Medical Supply Inc. | Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Traction Equipment|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Canes and/or … | Does not accept assignment |
National Provider Directory
National Provider DirectoryLocations
4509 Eagle Rock Blvd
#B
Los Angeles, CA 90041
Phone (323) 255-3504
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Sherman Oaks, CA
- NPI 1376856203
Durable Medical Equipment & Medical Supplies
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297987200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787961600000",
"number": "1104123652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4625 FIRST ST",
"address_2": "SUITE B",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "94566",
"telephone_number": "510-329-7997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4509 EAGLE ROCK BLVD",
"address_2": "STE B",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900413214",
"telephone_number": "323-255-3504",
"fax_number": "323-255-3504"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROHEALTH MEDICAL SUPPLY INC",
"organizational_subpart": "NO",
"enumeration_date": "2011-02-18",
"last_updated": "2026-08-29",
"certification_date": "2026-08-29",
"status": "A",
"authorized_official_last_name": "WAHAB",
"authorized_official_first_name": "ABDUL",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "510-329-7997",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "CA",
"license": "54295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.