Provider Demographics
NPI:1225117179
Name:CARLOS AND ROSALINA ORTEGA
Entity Type:Organization
Organization Name:CARLOS AND ROSALINA ORTEGA
Other - Org Name:WEST COAST MEDICAL EQUIPMENT REPAIR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSALINA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-837-4330
Mailing Address - Street 1:1431 TRUMAN ST
Mailing Address - Street 2:STE N
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-3236
Mailing Address - Country:US
Mailing Address - Phone:818-837-4330
Mailing Address - Fax:818-837-4331
Practice Address - Street 1:1431 TRUMAN ST
Practice Address - Street 2:STE N
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-3236
Practice Address - Country:US
Practice Address - Phone:818-837-4330
Practice Address - Fax:818-837-4331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5937250001Medicare NSC