Doctor Name: | MR. MATTHEW E ETUK |
NPI Number: | 1568594828 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 1407 Centinela Ave Inglewood, CA - 903021141 |
Business Phone Number: | 3103302955 |
Business Fax Number: | 3103302959 |
Mailing Address: | 1407 Centinela Ave, INGLEWOOD |
State: | CA |
Postal Code: | 903021141 |
Phone Number: | 3103302955 |
Fax Number: | 3103302959 |
NPI Enumeration Date: | 03/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |