Main Source Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

563007 Issued in CA

Legal business name

MAIN SOURCE MEDICAL SUPPLY

Practice address

3624 Randee Way
Fullerton, CA 92833-2830

Phone

(714) 584-0127

NPI assigned

Oct 28, 2011

Organization subpart

No

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

Authorized official

Name

Jorge Lomeli

Title

Owner

Phone

(714) 584-0127

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1319760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1932485406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928360632",
            "telephone_number": "714-584-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 RANDEE WAY",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332830",
            "telephone_number": "714-584-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN SOURCE MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-28",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "LOMELI",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-584-0127"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "563007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyeza Christel Magsino
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• Melody Mak, MA, APCC,MBA
• Penny Lane Makabenta, PA
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• Jordan Makkar
• Zaid Malas, RPH

• Durable Medical Equipment & Medical Supplies in Fullerton, CA
• Providers in Fullerton, 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 28, 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.