Media Mogul,Inc

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

Legal business name

MEDIA MOGUL,INC

Practice address

1223 W 127TH St
Los Angeles, CA 90044-1021

Phone

(323) 375-9973

NPI assigned

Mar 23, 2009

Organization subpart

Yes

Parent organization

MEDIA MOGUL,INCAs reported in NPPES

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

Authorized official

Name

Mr. Ray Du Boc Ali, DIRECTOR

Title

Director / President

Phone

(323) 375-9973

Specialties & licenses 1

Addresses

Other names 1

• Magic MANGOSTEEN Other name

Part of

Media Mogulinc

Locations

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237766400000",
    "number": "1295976108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9029 AIRPORT BLVD",
            "address_2": "88844",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900094801",
            "telephone_number": "323-375-9973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 W 127TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900441021",
            "telephone_number": "323-375-9973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIA MOGUL,INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDIA MOGUL,INC",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-03-23",
        "status": "A",
        "authorized_official_last_name": "DU BOC ALI",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "DIRECTOR / PRESIDENT",
        "authorized_official_telephone_number": "323-375-9973",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magic MANGOSTEEN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Parenteral & Enteral Nutrition Supplies (DME) in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Parenteral & Enteral Nutrition Supplies (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; 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.