Provider Demographics
NPI:1821377037
Name:MORI MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:MORI MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:MORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-659-4200
Mailing Address - Street 1:2320 LA MIRADA DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-7862
Mailing Address - Country:US
Mailing Address - Phone:760-659-4200
Mailing Address - Fax:
Practice Address - Street 1:2320 LA MIRADA DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081
Practice Address - Country:US
Practice Address - Phone:760-659-4200
Practice Address - Fax:760-856-5500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-05
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6679440001Medicare NSC