Provider Demographics
NPI:1619563483
Name:MEDICAL SPECIALTIES OF CALIFORNIA USA INC
Entity Type:Organization
Organization Name:MEDICAL SPECIALTIES OF CALIFORNIA USA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECY
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-474-1130
Mailing Address - Street 1:4 NW 108TH WAY
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1555
Mailing Address - Country:US
Mailing Address - Phone:954-474-1130
Mailing Address - Fax:
Practice Address - Street 1:7328 LAKESHORE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MI
Practice Address - Zip Code:48450-9004
Practice Address - Country:US
Practice Address - Phone:954-474-1130
Practice Address - Fax:954-424-6640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment