Provider Demographics
NPI:1881011708
Name:HUNTINGTON BEACH MEDICAL INC
Entity Type:Organization
Organization Name:HUNTINGTON BEACH MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZINK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-500-4015
Mailing Address - Street 1:PO BOX 3119
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92605-3119
Mailing Address - Country:US
Mailing Address - Phone:866-697-7167
Mailing Address - Fax:714-766-7241
Practice Address - Street 1:5702 BOLSA AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-1128
Practice Address - Country:US
Practice Address - Phone:866-697-7167
Practice Address - Fax:714-766-7241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3592439332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies