Provider Demographics
NPI:1326216722
Name:KRULAC MEDICAL INC
Entity Type:Organization
Organization Name:KRULAC MEDICAL INC
Other - Org Name:SEE THE TRAINER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:KRULAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-798-1914
Mailing Address - Street 1:PO BOX 3531
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-1531
Mailing Address - Country:US
Mailing Address - Phone:310-798-1914
Mailing Address - Fax:310-376-2748
Practice Address - Street 1:3848 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-2408
Practice Address - Country:US
Practice Address - Phone:310-798-1914
Practice Address - Fax:310-376-2748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA315362332B00000X
332B00000X
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6093550001Medicare NSC