Timothy P Obrien Dba Eta Supplies

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

TIMOTHY P OBRIEN DBA ETA SUPPLIES

Practice address

1518 Linda Vista Ave
Pasadena, CA 91103-1953

Phone

(626) 792-4700

NPI assigned

Jul 26, 2010

Last updated

Jul 26, 2010By 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

Mr. Edward J Panconi

Title

President

Phone

(626) 792-4700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280102400000",
    "number": "1366755845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 LINDA VISTA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031953",
            "telephone_number": "626-792-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 LINDA VISTA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031953",
            "telephone_number": "626-792-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY P OBRIEN DBA ETA SUPPLIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-26",
        "last_updated": "2010-07-26",
        "status": "A",
        "authorized_official_last_name": "PANCONI",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-792-4700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Pasadena, CA
• Providers in Pasadena, 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 Jul 26, 2010; 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.