Provider Demographics
NPI:1518517812
Name:LEGAL DEPOT INC
Entity Type:Organization
Organization Name:LEGAL DEPOT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GHAZI
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:JUBRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-423-4822
Mailing Address - Street 1:958 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-4228
Mailing Address - Country:US
Mailing Address - Phone:714-234-8228
Mailing Address - Fax:562-297-0344
Practice Address - Street 1:958 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-4228
Practice Address - Country:US
Practice Address - Phone:714-234-8228
Practice Address - Fax:562-297-0344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health