Provider Demographics
NPI:1740626258
Name:TRUE FUNCTIONAL AIRWAY LLC
Entity type:Organization
Organization Name:TRUE FUNCTIONAL AIRWAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHIRAZI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-496-5700
Mailing Address - Street 1:555 MARIN ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4236
Mailing Address - Country:US
Mailing Address - Phone:805-496-5700
Mailing Address - Fax:805-496-5719
Practice Address - Street 1:555 MARIN ST
Practice Address - Street 2:SUITE 108
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4236
Practice Address - Country:US
Practice Address - Phone:805-496-5700
Practice Address - Fax:805-496-5719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment