Provider Demographics
NPI:1871822122
Name:HARBOR VIEW MEDICAL SERVICES INC.
Entity Type:Organization
Organization Name:HARBOR VIEW MEDICAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-539-3500
Mailing Address - Street 1:24328 VERMONT AVE
Mailing Address - Street 2:SUITE 231
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2314
Mailing Address - Country:US
Mailing Address - Phone:310-539-3500
Mailing Address - Fax:310-517-0171
Practice Address - Street 1:24328 VERMONT AVE
Practice Address - Street 2:SUITE 231
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2314
Practice Address - Country:US
Practice Address - Phone:310-539-3500
Practice Address - Fax:310-517-0171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101-315059332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA101-315059OtherDME LICENCE
CA101-315059OtherCA SELLER'S PERMIT
CA101-315059OtherDME LICENCE