Provider Demographics
NPI:1871837500
Name:MEDICAL DISTRIBUTION PARTNERS INC
Entity Type:Organization
Organization Name:MEDICAL DISTRIBUTION PARTNERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MUHLENBRUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-519-1466
Mailing Address - Street 1:10650 REAGAN ST UNIT 1042
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-8856
Mailing Address - Country:US
Mailing Address - Phone:714-519-1466
Mailing Address - Fax:
Practice Address - Street 1:12022 REAGAN ST
Practice Address - Street 2:1042
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-4134
Practice Address - Country:US
Practice Address - Phone:714-519-1466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies