Healthcare Provider Details

I. General information

NPI: 1780680132
Provider Name (Legal Business Name): WHEELCHAIRS OF BERKELEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 11/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 SHATTUCK AVE
BERKELEY CA
94705-1808
US

IV. Provider business mailing address

2911 SHATTUCK AVE
BERKELEY CA
94705-1808
US

V. Phone/Fax

Practice location:
  • Phone: 510-549-8727
  • Fax: 510-540-1210
Mailing address:
  • Phone: 510-549-8727
  • Fax: 510-540-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number100834
License Number StateCA

VIII. Authorized Official

Name: JENICE S CHOU
Title or Position: CEO
Credential:
Phone: 650-270-5456