Capitol Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CAPITOL MEDICAL SUPPLY INC

Doing business as

Capitol Medical

Practice address

3629 N Sepulveda Blvd # 103
Manhattan Beach, CA 90266-3632

Phone

(424) 247-8165

Fax

(424) 247-8830

NPI assigned

Apr 8, 2019

Last updated

Jun 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kameria Ahmed Ibrahim

Title

Owner/President

Phone

(424) 247-8165

Specialties & licenses 1

Addresses

Other names 1

• CAPITOL MEDICAL Doing business as

Locations

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1124581053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3629 N SEPULVEDA BLVD # 103",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663632",
            "telephone_number": "424-247-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3629 N SEPULVEDA BLVD # 103",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663632",
            "telephone_number": "424-247-8165",
            "fax_number": "424-247-8830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITOL MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "KAMERIA AHMED",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "424-247-8165",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAPITOL MEDICAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CAPITOL MEDICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amie L Callon, PSY.D.
• Valerie Calvillo
• Sutharee Camluedet
• Robert W. Campbell, NCTMB
• Nazly Campos-Plata
• Carol Frey M.D., Inc
• Carol L. Meylan
• Carmen B Castillo, DDS
• Lisbeth Angelica Castillo, BCBA
• Amanda Cavan

• Durable Medical Equipment & Medical Supplies in Manhattan Beach, CA
• Providers in Manhattan Beach, 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 Jun 11, 2019; 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.