Provider Demographics
NPI:1871262352
Name:CITRINE MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:CITRINE MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESDIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHOT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAUMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMV
Authorized Official - Phone:818-319-3478
Mailing Address - Street 1:14103 VICTORY BLVD STE 13
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-1998
Mailing Address - Country:US
Mailing Address - Phone:818-510-0810
Mailing Address - Fax:
Practice Address - Street 1:14103 VICTORY BLVD STE 13
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1998
Practice Address - Country:US
Practice Address - Phone:818-388-0449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies