Provider Demographics
NPI:1639239247
Name:ADVENT MEDICAL EQUIPMENT AND SUPPLY INC
Entity Type:Organization
Organization Name:ADVENT MEDICAL EQUIPMENT AND SUPPLY INC
Other - Org Name:ADVENT MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:ABAYA
Authorized Official - Last Name:PAREL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-255-8008
Mailing Address - Street 1:5806 MONTEREY ROAD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-4926
Mailing Address - Country:US
Mailing Address - Phone:323-255-8008
Mailing Address - Fax:323-255-8118
Practice Address - Street 1:5806 MONTEREY RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-4326
Practice Address - Country:US
Practice Address - Phone:323-255-8008
Practice Address - Fax:323-255-8118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME02187GMedicaid
CA5123650001Medicare NSC