Provider Demographics
NPI:1609982776
Name:OPI MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:OPI MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LAL
Authorized Official - Middle Name:K
Authorized Official - Last Name:PUNWANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-964-0350
Mailing Address - Street 1:10958 WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708
Mailing Address - Country:US
Mailing Address - Phone:714-964-0350
Mailing Address - Fax:714-964-9920
Practice Address - Street 1:10958 WARNER AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708
Practice Address - Country:US
Practice Address - Phone:714-964-0350
Practice Address - Fax:714-964-9920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100427332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME01264FMedicaid
0526510001Medicare ID - Type Unspecified