Bernard S Gibeson

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1317830001 Issued in CA

Legal business name

BERNARD S GIBESON

Doing business as

Conquest Medical Supply

Practice address

1900 W Redondo Beach Blvd
Gardena, CA 90247-3624

Phone

(310) 630-5885

Fax

(310) 630-0189

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Bernard S Gibeson

Title

Owner

Phone

(310) 630-5885

Specialties & licenses 1

Addresses

Other names 1

• CONQUEST MEDICAL SUPPLY Doing business as

Locations

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1821208943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W REDONDO BEACH BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473624",
            "telephone_number": "310-630-5885",
            "fax_number": "310-630-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W REDONDO BEACH BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473624",
            "telephone_number": "310-630-5885",
            "fax_number": "310-630-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERNARD S GIBESON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "GIBESON",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-630-5885",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "1317830001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONQUEST MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Gardena, CA
• Providers in Gardena, 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 Jun 20, 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.