Ida Med Medical Equipment

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

100642 Issued in CA

Legal business name

IDA MED MEDICAL EQUIPMENT

Practice address

12792 Valley View St
Ste C
Garden Grove, CA 92845-2509

Phone

(714) 894-1818

Fax

(714) 894-3121

NPI assigned

Sep 2, 2005

Organization subpart

No

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

Authorized official

Name

Mehdi Abhari

Title

Business Owner

Phone

(714) 894-1818

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1245224427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12792 VALLEY VIEW ST",
            "address_2": "STE C",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92845",
            "telephone_number": "714-894-1818",
            "fax_number": "714-894-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12792 VALLEY VIEW ST",
            "address_2": "STE C",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928452509",
            "telephone_number": "714-894-1818",
            "fax_number": "714-894-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDA MED MEDICAL EQUIPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-02",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "ABHARI",
        "authorized_official_first_name": "MEHDI",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "714-894-1818"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "100642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME03026F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID PROVIDER NUMBER",
            "identifier": "4204220001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Garden Grove, CA
• Providers in Garden Grove, 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 27, 2008; 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.