Provider Demographics
NPI:1164629879
Name:RACHEL M LAURANT
Entity Type:Organization
Organization Name:RACHEL M LAURANT
Other - Org Name:PLATINUM MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAURANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-338-9131
Mailing Address - Street 1:5710 W MANCHESTER AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-4423
Mailing Address - Country:US
Mailing Address - Phone:310-338-9131
Mailing Address - Fax:310-338-9129
Practice Address - Street 1:5710 W MANCHESTER AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-4423
Practice Address - Country:US
Practice Address - Phone:310-338-9131
Practice Address - Fax:310-338-9129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47765332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6033210001Medicare NSC