Provider Demographics
NPI:1386536746
Name:CORANOVA MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:CORANOVA MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EZZAT
Authorized Official - Middle Name:SAEID
Authorized Official - Last Name:ELSAYED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-232-1089
Mailing Address - Street 1:3330 HARBOR BLVD STE 242
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-1502
Mailing Address - Country:US
Mailing Address - Phone:949-232-1089
Mailing Address - Fax:949-693-0494
Practice Address - Street 1:3330 HARBOR BLVD STE 242
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-1502
Practice Address - Country:US
Practice Address - Phone:949-232-1089
Practice Address - Fax:949-693-0494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies