Provider Demographics
NPI:1376560060
Name:TOPANGA MEDCARE SUPPLIES
Entity Type:Organization
Organization Name:TOPANGA MEDCARE SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALFIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-348-0175
Mailing Address - Street 1:21822 SHERMAN WAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1942
Mailing Address - Country:US
Mailing Address - Phone:818-348-0175
Mailing Address - Fax:818-348-0176
Practice Address - Street 1:21822 SHERMAN WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1942
Practice Address - Country:US
Practice Address - Phone:818-348-0175
Practice Address - Fax:818-348-0176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102659332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4732780001Medicare ID - Type UnspecifiedPROVIDER