Organization
ICEDOWN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA CAVANAUGH (OFFICE ADMIN)
(909) 307-8503
Entity
Organization
Contact information
Practice address
2232 VERUS ST, STE 2, SAN DIEGO, CA 92154-4706
(909) 307-8503
(909) 307-8510
Mailing address
2232 VERUS ST, STE 2, SAN DIEGO, CA 92154-4706
(909) 307-8503
(909) 307-8510
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/24/2008
Last updated
07/24/2008
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