Provider Demographics
NPI:1619002235
Name:PTRN DME INC
Entity Type:Organization
Organization Name:PTRN DME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGARIT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYRAPETYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-381-1183
Mailing Address - Street 1:4201 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3601
Mailing Address - Country:US
Mailing Address - Phone:818-381-1183
Mailing Address - Fax:323-843-9771
Practice Address - Street 1:4201 WILSHIRE BLVD
Practice Address - Street 2:SUITE 111
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3601
Practice Address - Country:US
Practice Address - Phone:818-381-1183
Practice Address - Fax:323-843-9771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46272332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5920040001Medicare NSC