Provider Demographics
NPI:1538339668
Name:LA MESA MED EQUIPMENT INC
Entity type:Organization
Organization Name:LA MESA MED EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOVSEP
Authorized Official - Middle Name:
Authorized Official - Last Name:MELKONYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-644-5757
Mailing Address - Street 1:8753 LA MESA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-5404
Mailing Address - Country:US
Mailing Address - Phone:619-644-5757
Mailing Address - Fax:619-644-5700
Practice Address - Street 1:8753 LA MESA BLVD
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-5404
Practice Address - Country:US
Practice Address - Phone:619-644-5757
Practice Address - Fax:619-644-5700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6377780001Medicare NSC