Provider Demographics
NPI:1497793053
Name:CEO MEDICAL
Entity Type:Organization
Organization Name:CEO MEDICAL
Other - Org Name:CEO MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:UGOCHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:ORANU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-406-3980
Mailing Address - Street 1:21150 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4602
Mailing Address - Country:US
Mailing Address - Phone:310-406-3980
Mailing Address - Fax:
Practice Address - Street 1:21150 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4602
Practice Address - Country:US
Practice Address - Phone:310-406-3980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44460332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5653600001Medicare ID - Type Unspecified