Provider Demographics
NPI:1619406022
Name:ADONAI MEDICAL LLC
Entity Type:Organization
Organization Name:ADONAI MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VAHE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:AZATUNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-410-2400
Mailing Address - Street 1:3354 MATHER FIELD RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-5966
Mailing Address - Country:US
Mailing Address - Phone:916-410-2400
Mailing Address - Fax:916-410-2400
Practice Address - Street 1:3354 MATHER FIELD RD
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-5966
Practice Address - Country:US
Practice Address - Phone:916-410-2400
Practice Address - Fax:916-410-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA326065332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies