Canaan Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

6057490002 Issued in CA

Legal business name

CANAAN MEDICAL SUPPLY, INC.

Practice address

903 S Crenshaw Blvd
Suite 102a
Los Angeles, CA 90019-1964

Phone

(323) 935-4000

Fax

(323) 937-8970

NPI assigned

Jun 26, 2006

Organization subpart

No

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

Authorized official

Name

Bok Hee Cha

Title

President

Phone

(323) 935-4000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1932135258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 S CRENSHAW BLVD",
            "address_2": "SUITE 102A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191964",
            "telephone_number": "323-935-4000",
            "fax_number": "323-937-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 S CRENSHAW BLVD",
            "address_2": "SUITE 102A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191964",
            "telephone_number": "323-935-4000",
            "fax_number": "323-937-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANAAN MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "CHA",
        "authorized_official_first_name": "BOK HEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-935-4000"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "6057490002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maricella Campuzano
• Tatiana Campuzano, MD
• Rashida Taher Campwala, M.D.
• Erin Camron, N.P.
• Can DO Kids Inc
• Canaan Pharmacy
• Canaan Surgery Center, Inc.
• Whitney Canady
• Amy Guadalupe Canal, BA
• Cinzia Canale Fossa, M.A.

• Durable Medical Equipment & Medical Supplies in Los Angeles, CA
• Providers in Los Angeles, 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 Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.