Ethos Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ETHOS MEDICAL SUPPLY, INC.

Practice address

185 Paularino Ave Ste C107
Costa Mesa, CA 92626-3330

Phone

(949) 354-3458

NPI assigned

Sep 5, 2022

Organization subpart

No

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

Authorized official

Name

Viviann Valenzuela

Title

Ceo

Phone

(949) 354-3458

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1821719329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 PAULARINO AVE STE C107",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 PAULARINO AVE STE C107",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263330",
            "telephone_number": "949-354-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHOS MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-05",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "VALENZUELA",
        "authorized_official_first_name": "VIVIANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-354-3458"
    },
    "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 Costa Mesa, CA
• Providers in Costa Mesa, 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 May 31, 2023; 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.