Provider Demographics
NPI:1841488988
Name:MEDICAL PROVIDERS, INC.
Entity type:Organization
Organization Name:MEDICAL PROVIDERS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIDARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-290-4156
Mailing Address - Street 1:4214 GREEN RIVER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92880-1669
Mailing Address - Country:US
Mailing Address - Phone:866-535-2727
Mailing Address - Fax:866-535-1787
Practice Address - Street 1:4214 GREEN RIVER RD STE 200
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880-1669
Practice Address - Country:US
Practice Address - Phone:866-535-2727
Practice Address - Fax:866-535-1787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6019190002Medicare NSC