Provider Demographics
NPI:1548211089
Name:DYNAMIC MEDICAL SYSTEMS, INC.
Entity Type:Organization
Organization Name:DYNAMIC MEDICAL SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-225-9080
Mailing Address - Street 1:2811 E ANA ST
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90221-5601
Mailing Address - Country:US
Mailing Address - Phone:800-225-9080
Mailing Address - Fax:866-434-3610
Practice Address - Street 1:11616 E MONTGOMERY DR
Practice Address - Street 2:SUITE 37
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-6607
Practice Address - Country:US
Practice Address - Phone:800-225-9080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103253332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9055732Medicaid
CA1089440001Medicare ID - Type Unspecified