Provider Demographics
NPI:1669565271
Name:ALPINE OXYGEN HOME CARE LLC
Entity type:Organization
Organization Name:ALPINE OXYGEN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHIMZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-204-6444
Mailing Address - Street 1:2818 LA CIENEGA AVE.
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034
Mailing Address - Country:US
Mailing Address - Phone:310-204-6444
Mailing Address - Fax:310-204-6440
Practice Address - Street 1:2818 LA CIENEGA AVE.
Practice Address - Street 2:SUITE 305
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034
Practice Address - Country:US
Practice Address - Phone:310-204-6444
Practice Address - Fax:310-204-6440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4374800001Medicare NSC