Active Medical Equipment & Supplis

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

103338 Issued in CA

Legal business name

ACTIVE MEDICAL EQUIPMENT & SUPPLIS

Practice address

1704 W Manchester Ave
Suite 204D
Los Angeles, CA 90047-3034

Phone

(323) 758-7550

Fax

(323) 758-5550

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Alula Bekele Berhane

Title

Owner/Partner

Phone

(310) 714-9667

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1619993029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 W MANCHESTER AVE",
            "address_2": "SUITE 204D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900473034",
            "telephone_number": "323-758-7550",
            "fax_number": "323-758-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 W MANCHESTER AVE",
            "address_2": "SUITE 204D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900473034",
            "telephone_number": "323-758-7550",
            "fax_number": "323-758-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE MEDICAL EQUIPMENT & SUPPLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BERHANE",
        "authorized_official_first_name": "ALULA",
        "authorized_official_middle_name": "BEKELE",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "310-714-9667",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "103338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Los Angeles, CA
• Providers in Los Angeles, 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 21, 2022; 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.