# BREAKWATER MEDICAL LLC

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

## Provider details

- **NPI number:** 1710236344
- **Authorized official:** MR. PATRICK CAHILL (OWNER)
- **Authorized official phone:** (714) 347-1010

## Contact information

- **Practice address:** 720 MILWOOD AVE, VENICE, CA 90291-3829
- **Practice address phone:** (714) 347-1010
- **Practice address fax:** (714) 647-1245
- **Mailing address:** 210 N TUSTIN AVE, SANTA ANA, CA 92705-3807
- **Mailing address phone:** (714) 347-1010
- **Mailing address fax:** (714) 647-1245

## Taxonomy

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

## Other

- **Enumeration date:** 08/29/2012
- **Last updated:** 08/29/2012