NPIMap

Organization Active NPI

Wicked Medical

  • Durable Medical Equipment & Medical Supplies
  • South Gate, CA
National Provider Identifier
1144556390
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
WICKED MEDICAL
Practice address
5580 Imperial Hwy
South Gate, CA 90280-7418
Phone
(855) 850-5888
NPI assigned
Oct 22, 2009
Last updated
Jul 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Authorized official

Name
Mr. Joey Tusia
Title
President
Phone
(562) 843-2573

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

5580 Imperial Hwy
South Gate, CA 90280-7418

Mailing address

5580 Imperial Hwy
South Gate, CA 90280-7418

National Provider Directory

National Provider Directory
Tax ID family
My DME3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1144556390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5580 IMPERIAL HWY",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902807418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5580 IMPERIAL HWY",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902807418",
            "telephone_number": "855-850-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICKED MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-22",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "TUSIA",
        "authorized_official_first_name": "JOEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-843-2573",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.