Provider Demographics
NPI:1679580765
Name:VICTORIA NELLIE AFRIYIE
Entity Type:Organization
Organization Name:VICTORIA NELLIE AFRIYIE
Other - Org Name:FOUR-POINT MEDICAL EQUIPMENT & SUPP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:NELLIE
Authorized Official - Last Name:AFRIYIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-299-1338
Mailing Address - Street 1:3756 SANTA ROSALIA DR
Mailing Address - Street 2:STE 225
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-3616
Mailing Address - Country:US
Mailing Address - Phone:323-299-1338
Mailing Address - Fax:323-299-1331
Practice Address - Street 1:3756 SANTA ROSALIA DR
Practice Address - Street 2:STE 225
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-3616
Practice Address - Country:US
Practice Address - Phone:323-299-1338
Practice Address - Fax:323-299-1331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103746332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03374FMedicaid
CA5206500001Medicare NSC