Provider Demographics
NPI:1710972377
Name:NORTH AMERICAN DISTRIBUTORS, INC.
Entity Type:Organization
Organization Name:NORTH AMERICAN DISTRIBUTORS, INC.
Other - Org Name:REHAB SOLUTIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, BUSINESS & LEGAL AFFAIRS
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:FONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-553-0263
Mailing Address - Street 1:16520 ASTON ST
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-4805
Mailing Address - Country:US
Mailing Address - Phone:949-553-0263
Mailing Address - Fax:949-623-2202
Practice Address - Street 1:16520 ASTON ST
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-4805
Practice Address - Country:US
Practice Address - Phone:949-553-0263
Practice Address - Fax:949-623-2202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100196332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03055FOtherMEDI-CAL
CA0533220001Medicare ID - Type Unspecified