Provider Demographics
NPI:1356561906
Name:KOBIL MEDICAL SUPPLIES
Entity type:Organization
Organization Name:KOBIL MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:ABIOLA
Authorized Official - Last Name:OBILEYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-877-1212
Mailing Address - Street 1:444 E FOOTHILL BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-5180
Mailing Address - Country:US
Mailing Address - Phone:909-877-1212
Mailing Address - Fax:909-877-1211
Practice Address - Street 1:444 E FOOTHILL BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-5180
Practice Address - Country:US
Practice Address - Phone:909-877-1212
Practice Address - Fax:909-877-1211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44852332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5540450001Medicare ID - Type Unspecified