Organization
WAVE MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WEIDINGER (PRESIDENT)
(858) 229-7297
Entity
Organization
Contact information
Practice address
4766 EDISON ST, SAN DIEGO, CA 92117-6741
(858) 822-9729
Mailing address
4766 EDISON ST, SAN DIEGO, CA 92117-6741
(858) 822-9729
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
06/28/2022
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