South Bay DME, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

78487 Issued in CA

Legal business name

SOUTH BAY DME, LLC

Practice address

285 W 6TH St Apt 511
San Pedro, CA 90731-3381

Phone

(310) 418-0308

Fax

(310) 921-5660

NPI assigned

Jun 28, 2015

Organization subpart

No

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

Authorized official

Name

Joshua Cleveland

Title

Owner

Phone

(310) 418-0308

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1435449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460937600000",
    "number": "1598147332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28364 S WESTERN AVE # 482",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902751434",
            "telephone_number": "310-418-0308",
            "fax_number": "310-921-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 W 6TH ST APT 511",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313381",
            "telephone_number": "310-418-0308",
            "fax_number": "310-921-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY DME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-28",
        "last_updated": "2016-04-18",
        "status": "A",
        "authorized_official_last_name": "CLEVELAND",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-418-0308"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "78487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in San Pedro, CA
• Providers in San Pedro, 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 Apr 18, 2016; 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.