# ICEDOWN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508021908
- **Authorized official:** PAULA CAVANAUGH (OFFICE ADMIN)
- **Authorized official phone:** (909) 307-8503

## Contact information

- **Practice address:** 2232 VERUS ST, STE 2, SAN DIEGO, CA 92154-4706
- **Practice address phone:** (909) 307-8503
- **Practice address fax:** (909) 307-8510
- **Mailing address:** 2232 VERUS ST, STE 2, SAN DIEGO, CA 92154-4706
- **Mailing address phone:** (909) 307-8503
- **Mailing address fax:** (909) 307-8510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 07/24/2008
- **Last updated:** 07/24/2008