Provider Demographics
NPI:1487632550
Name:ARTUR STEPANYAN
Entity Type:Organization
Organization Name:ARTUR STEPANYAN
Other - Org Name:MONTEBELLO MEDICALL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTUR
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-722-2900
Mailing Address - Street 1:2124 W. WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4013
Mailing Address - Country:US
Mailing Address - Phone:323-722-2900
Mailing Address - Fax:323-722-2722
Practice Address - Street 1:2124 W WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4013
Practice Address - Country:US
Practice Address - Phone:323-722-2900
Practice Address - Fax:323-722-2722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA43031OtherMEDICAL DEVICE RETAILER
5389710001Medicare NSC