South Bay Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

46263 Issued in CA

Legal business name

SOUTH BAY MEDICAL SUPPLY

Practice address

735 Broad Ave
Wilmington, CA 90744-5833

Phone

(310) 522-4200

Fax

(310) 522-4244

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Gabriel C Ejizu

Title

Owner

Phone

(310) 522-4200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1578613428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 663",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907480663",
            "telephone_number": "310-522-4200",
            "fax_number": "310-522-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 BROAD AVE",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907445833",
            "telephone_number": "310-522-4200",
            "fax_number": "310-522-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "EJIZU",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-522-4200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "46263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Denise Smith, LVN
• Rachel Irene Smith, LVN
• Brandon Rene Solares
• South Bay Center for Counseling
• South Bay Express Nursing , Inc.
• South Bay Sunset Pavilion
• King Anthony Sparks, PHLEBOTOMY TECHNICIA
• Starship Medical Corporation
• Starship Medical Corporation
• Stevedores Physicians Group a PC

• Durable Medical Equipment & Medical Supplies in Wilmington, CA
• Providers in Wilmington, 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 Jan 9, 2008; 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.