Ultra Med, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ULTRA MED, INC.

Practice address

457 W Allen Ave Ste 118
San Dimas, CA 91773-1489

Phone

(909) 206-0563

NPI assigned

Mar 20, 2019

Organization subpart

No

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

Authorized official

Name

Darin Flashberg

Title

President

Phone

(909) 206-0563

Specialties & licenses 1

Addresses

Other names 1

• na Former legal business name

Locations

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553040000000",
    "number": "1497215016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 W ALLEN AVE STE 118",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 W ALLEN AVE STE 118",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731489",
            "telephone_number": "909-206-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTRA MED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-20",
        "status": "A",
        "authorized_official_last_name": "FLASHBERG",
        "authorized_official_first_name": "DARIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-206-0563"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "na",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in San Dimas, CA
• Providers in San Dimas, 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 Mar 20, 2019; 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.