Organization
JACK QUEREQUINCIA
Active
Other names
Simi Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
JACK DANIEL QUEREQUINCIA (OWNER)
(805) 581-5905
Entity
Organization
Contact information
Practice address
2375 SYCAMORE DR, SUITE 4, SIMI VALLEY, CA 93065-2787
(805) 581-5905
(805) 581-1478
Mailing address
2375 SYCAMORE DR, SUITE 4, SIMI VALLEY, CA 93065-2787
(805) 581-5905
(805) 581-1478
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/02/2005
Last updated
08/22/2020
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