Iceberg Health Care Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ICEBERG HEALTH CARE INC.

Practice address

3631 Crenshaw Blvd Ste 111
Los Angeles, CA 90016-4869

Phone

(323) 733-5153

Fax

(323) 733-5142

NPI assigned

Aug 16, 2006

Organization subpart

No

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

Authorized official

Name

Andery Yevchuk

Title

President

Phone

(323) 733-5153

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265545958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3631 CRENSHAW BLVD STE 111",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900164869",
            "telephone_number": "323-733-5153",
            "fax_number": "323-733-5142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 CRENSHAW BLVD STE 111",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900164869",
            "telephone_number": "323-733-5153",
            "fax_number": "323-733-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICEBERG HEALTH CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YEVCHUK",
        "authorized_official_first_name": "ANDERY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-733-5153"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Megan Christina Ichinose

• Durable Medical Equipment & Medical Supplies in Los Angeles, CA
• Providers in Los Angeles, 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 Aug 22, 2020; 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.