Provider Demographics
NPI:1114384641
Name:PMI O2 LLC
Entity Type:Organization
Organization Name:PMI O2 LLC
Other - Org Name:O2 RELIEF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALT
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-656-3462
Mailing Address - Street 1:2458 ALTON PKWY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-5037
Mailing Address - Country:US
Mailing Address - Phone:949-656-3462
Mailing Address - Fax:949-656-3553
Practice Address - Street 1:2458 ALTON PKWY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-5037
Practice Address - Country:US
Practice Address - Phone:949-656-3462
Practice Address - Fax:949-656-3553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2019-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies