Tripple O Evergreen

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

TRIPPLE O EVERGREEN

Practice address

17420 Avalon Blvd
207
Carson, CA 90746-1564

Phone

(310) 965-9039

Fax

(310) 965-9099

NPI assigned

Feb 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ogban O Ogbu, OWNER

Title

Ceo

Phone

(310) 965-9039

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700850450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17420 AVALON BLVD",
            "address_2": "207",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461564",
            "telephone_number": "310-965-9039",
            "fax_number": "310-965-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17420 AVALON BLVD",
            "address_2": "207",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461564",
            "telephone_number": "310-965-9039",
            "fax_number": "310-965-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIPPLE O EVERGREEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OGBU",
        "authorized_official_first_name": "OGBAN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-965-9039",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Carson, CA
• Providers in Carson, 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 Aug 22, 2020; 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.