Organization
SGBA DIVERSIFIED INC
Active
Other names
San Diego Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN J GRISWOLD (PRESIDENT)
(619) 644-2170
Entity
Organization
Contact information
Practice address
5735 KEARNY VILLA RD STE 101, SAN DIEGO, CA 92123-1138
(619) 644-2170
(619) 644-2174
Mailing address
5735 KEARNY VILLA RD STE 101, SAN DIEGO, CA 92123-1138
(619) 644-2170
(619) 644-2174
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
97888
CA
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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