MEDICARE: GO2MEDICAL, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)		CA

General Provider Information

NPI Number	:	1821353335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GO2MEDICAL, LLC

Provider Business Mailing Address
First Line	:	2003 S EL CAMINO REAL
Second Line	:	SUITE 204
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6214
Country	:	US
Telephone Number	:	888-405-2505
Fax Number	:

Provider Business Practice Location Address
First Line	:	2003 S EL CAMINO REAL
Second Line	:	SUITE 204
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6214
Country	:	US
Telephone Number	:	888-405-2505
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MARK DEL LLANO
Credential	:
Telephone Number	:	888-405-2505

Provider Enumeration Date	:	07/10/2012
Last Update Date	:	07/21/2022

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Directions to “GO2MEDICAL, LLC ” Practice Location

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