Organization
SHIELD CALIFORNIA HEALTH CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE SUOR (VP GENERAL MANAGER)
(661) 294-4200
Entity
Organization
Contact information
Practice address
3290 E GUASTI RD, SUITE 130, ONTARIO, CA 91761-8647
(909) 512-9290
(909) 512-9288
Mailing address
27911 FRANKLIN PKWY, VALENCIA, CA 91355-4110
(661) 294-4200
(661) 294-1042
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
103749
CA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
103749
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME03402F
—
CA
Enumeration date
08/18/2006
Last updated
01/14/2025
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