# LIFE FORCE DME

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

## Provider details

- **NPI number:** 1730454448
- **Authorized official:** MR. JAVIER HERRERA JR. (C.E.O)
- **Authorized official phone:** (619) 250-1703

## Contact information

- **Practice address:** 511 E SAN YSIDRO BLVD \# 6128, SAN YSIDRO, CA 92173-3150
- **Practice address phone:** (619) 250-1703
- **Mailing address:** 511 E SAN YSIDRO BLVD \# 6128, SAN YSIDRO, CA 92173-3150
- **Mailing address phone:** (619) 250-1703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 070094 | CA | Yes |

## Other

- **Enumeration date:** 03/13/2012
- **Last updated:** 03/13/2012