Divine Medical Supply, Incorporated

Primary specialty

Nursing Facility Supplies (DME)Taxonomy code 332BN1400X

Legal business name

DIVINE MEDICAL SUPPLY, INCORPORATED

Practice address

285 S Gilbert St
Fullerton, CA 92833-2908

Phone

(714) 457-2049

Fax

(714) 930-9435

NPI assigned

Apr 23, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Femi O Abatan

Title

President

Phone

(714) 225-4762

Specialties & licenses 2

Addresses

Other names 1

• Divine Medical Supply Doing business as

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

{
    "created_epoch": "1303516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303516800000",
    "number": "1891086914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 S GILBERT ST",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332908",
            "telephone_number": "714-457-2049",
            "fax_number": "714-930-9435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 S GILBERT ST",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332908",
            "telephone_number": "714-457-2049",
            "fax_number": "714-930-9435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE MEDICAL SUPPLY, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-23",
        "last_updated": "2011-04-23",
        "status": "A",
        "authorized_official_last_name": "ABATAN",
        "authorized_official_first_name": "FEMI",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-225-4762",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Dinh
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• Steven Nghi Dinh
• Maria Guadalupe Diosdado, NP
• Dhanya A Divakaran, D.D.S.
• Julia Dixon
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• Anthony-Tu DO
• Jocelyn DO

• Nursing Facility Supplies (DME) in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Nursing Facility Supplies (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2011; 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.