Evolution Medical Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

EVOLUTION MEDICAL SUPPLIES LLC

Practice address

6803 International Ave Ste 201
Cypress, CA 90630-5114

Phone

(714) 869-5650

Fax

(562) 741-5889

NPI assigned

Jul 7, 2022

Organization subpart

No

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

Authorized official

Name

Colin Mativo

Title

Manager

Phone

(714) 869-5650

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Evo-med Supplies Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750464000000",
    "number": "1477286227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6803 INTERNATIONAL AVE STE 201",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906305114",
            "telephone_number": "714-869-5650",
            "fax_number": "562-741-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6803 INTERNATIONAL AVE STE 201",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906305114",
            "telephone_number": "714-869-5650",
            "fax_number": "562-741-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-07",
        "last_updated": "2025-06-21",
        "certification_date": "2025-06-21",
        "status": "A",
        "authorized_official_last_name": "MATIVO",
        "authorized_official_first_name": "COLIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "714-869-5650"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HDMR LICENSE",
            "identifier": "125409",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELLERS PERMIT",
            "identifier": "218049632-00001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evo-med Supplies",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evo-med Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Cypress, CA
• Providers in Cypress, 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 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.