Provider Demographics
NPI:1629853577
Name:DYNAKINETICS ASSISTIVE MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:DYNAKINETICS ASSISTIVE MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REMBRANDT
Authorized Official - Middle Name:
Authorized Official - Last Name:SORIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-332-7748
Mailing Address - Street 1:15439 DEVONSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-2618
Mailing Address - Country:US
Mailing Address - Phone:424-438-1131
Mailing Address - Fax:888-516-8588
Practice Address - Street 1:15439 DEVONSHIRE ST
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-2618
Practice Address - Country:US
Practice Address - Phone:424-438-1131
Practice Address - Fax:888-516-8588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies