Provider Demographics
NPI:1043304314
Name:NEA CORPORATION
Entity Type:Organization
Organization Name:NEA CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VARTAN
Authorized Official - Middle Name:MKHSI
Authorized Official - Last Name:GEVORKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-461-9451
Mailing Address - Street 1:5207 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027
Mailing Address - Country:US
Mailing Address - Phone:323-461-9454
Mailing Address - Fax:323-461-7134
Practice Address - Street 1:2012 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057
Practice Address - Country:US
Practice Address - Phone:213-413-3111
Practice Address - Fax:213-413-4428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5158630001Medicare ID - Type Unspecified