Provider Demographics
NPI:1073551446
Name:NATIONWIDE MEDICAL, INC.
Entity Type:Organization
Organization Name:NATIONWIDE MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-338-3502
Mailing Address - Street 1:5230 LAS VIRGENES RD STE 105
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3447
Mailing Address - Country:US
Mailing Address - Phone:818-338-3500
Mailing Address - Fax:818-338-3501
Practice Address - Street 1:5230 LAS VIRGENES RD STE 105
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3447
Practice Address - Country:US
Practice Address - Phone:818-338-3500
Practice Address - Fax:818-338-3501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45263332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ66262ZOtherBS OF CA PROVIDER #
CAZZZ66262ZOtherBS OF CA PROVIDER #
CA=========OtherUNITED HEALTHCARE PROV #
CA=========OtherBC OF CA PROVIDER #
CA5567030001Medicare NSC