Miracle Medical

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MIRACLE MEDICAL

Practice address

2025 Suede St
Simi Valley, CA 93063-4012

Phone

(805) 432-0072

NPI assigned

Jun 14, 2010

Organization subpart

No

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

Authorized official

Name

Randy Ababseh

Title

Sole Member

Phone

(805) 432-0072

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276473600000",
    "number": "1679894620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SUEDE ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930634012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 SUEDE ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930634012",
            "telephone_number": "805-432-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-14",
        "last_updated": "2010-06-14",
        "status": "A",
        "authorized_official_last_name": "ABABSEH",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "805-432-0072"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 14, 2010; 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.