NPIMap

Organization Active NPI

MLC Medical Marketing Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Glendora, CA
National Provider Identifier
1982785754
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
100140 Issued in CA
Legal business name
MLC MEDICAL MARKETING GROUP, INC.
Practice address
626 W Route 66
Suite C
Glendora, CA 91740-4103
Phone
(626) 335-5418
Fax
(626) 852-9880
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert Carlos Cantoria
Title
Ceo President.
Phone
(626) 335-5418

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 100140 CA Primary

Addresses

Primary practice location

626 W Route 66
Suite C
Glendora, CA 91740-4103

Mailing address

626 W Route 66
Suite C
Glendora, CA 91740-4103
Phone (626) 335-5418

Other identifiers 1

IdentifierTypeStateIssuer
DME01936GMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930015044 CA DME Supplier - Medical Supply Company 7911026224 Practice locations: Glendora, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
MLC Medical Marketing Group Inc626 W Route 66, Glendora, CA 91740-4167(626) 335-5418 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Pneumatic Compression Devices and/or Supplies|Support Surfaces: Pressure Reducing Beds/Mats/Pads|(TENS) T… Accepts assignmentParticipating since Jan 1, 2001

National Provider Directory

National Provider Directory
Tax ID family
MLC Medical Marketing Group Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

626 W Route 66
Ste C
Glendora, CA 91740
Phone (626) 335-5418

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982785754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 W ROUTE 66",
            "address_2": "SUITE C",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404103",
            "telephone_number": "626-335-5418",
            "fax_number": "626-852-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 W ROUTE 66",
            "address_2": "SUITE C",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404103",
            "telephone_number": "626-335-5418",
            "fax_number": "626-852-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLC MEDICAL MARKETING GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CANTORIA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CARLOS",
        "authorized_official_title_or_position": "CEO PRESIDENT.",
        "authorized_official_telephone_number": "626-335-5418",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "100140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME01936G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.