Provider Demographics
NPI:1770237372
Name:IZAMASI DME LLC
Entity Type:Organization
Organization Name:IZAMASI DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARION
Authorized Official - Middle Name:D
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-926-0353
Mailing Address - Street 1:17075 LASSEN ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-1940
Mailing Address - Country:US
Mailing Address - Phone:323-926-0353
Mailing Address - Fax:
Practice Address - Street 1:17075 LASSEN ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-1940
Practice Address - Country:US
Practice Address - Phone:323-926-0353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-11
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies