1780859629 NPI number — MOZENA PUBLISHING, INC.

Table of content: (NPI 1780859629)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780859629 NPI number — MOZENA PUBLISHING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOZENA PUBLISHING, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MOZENA MEDICAL SUPPLIES AND EQUIPMENT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780859629
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 92679
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONG BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90809-2679
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-494-9606
Provider Business Mailing Address Fax Number:
310-518-4446

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3935 E ANAHEIM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90804-4101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-494-9606
Provider Business Practice Location Address Fax Number:
310-518-4446
Provider Enumeration Date:
04/22/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MOZENA
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
PAUL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
310-990-8398

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  47979 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BC3200X , with the licence number: 47979 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BD1200X , with the licence number: 47979 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BN1400X , with the licence number: 47979 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X , with the licence number: 47979 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 47979 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 47979 . This is a "HOME MEDICAL DEVICE RETAIL LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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