Organization
SOUTH BAY MEDIQUIPMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JULIAN GARCIA (PRESIDENT)
(619) 994-6942
Entity
Organization
Contact information
Practice address
1206 THIRD AVE, CHULA VISTA, CA 91911-3203
(619) 794-2099
(619) 362-9616
Mailing address
1206 THIRD AVE, CHULA VISTA, CA 91911-3203
(619) 794-2099
(619) 362-9616
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
77206
HOME MEDICAL DEVICE RETAIL LICENSE
CA
Enumeration date
08/12/2015
Last updated
09/18/2015
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