Provider Demographics
NPI:1447948617
Name:QUALIUM CORP.
Entity type:Organization
Organization Name:QUALIUM CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANOOSHIRAVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSTOWFIPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:408-499-7597
Mailing Address - Street 1:1845 WINCHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-1165
Mailing Address - Country:US
Mailing Address - Phone:866-887-6673
Mailing Address - Fax:866-442-7632
Practice Address - Street 1:50 OAK LN
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2629
Practice Address - Country:US
Practice Address - Phone:866-887-6673
Practice Address - Fax:866-442-7632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies