Healthcare Provider Details
I. General information
NPI: 1972263580
Provider Name (Legal Business Name): STABILITY MEDICAL EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/22/2021
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
815 THIRD AVE STE 311
CHULA VISTA CA
91911-1310
US
IV. Provider business mailing address
815 THIRD AVE STE 311
CHULA VISTA CA
91911-1310
US
V. Phone/Fax
- Phone: 619-732-3060
- Fax: 844-288-8144
- Phone: 619-732-3060
- Fax: 844-288-8144
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
FERNANDO
VALENZUELA-VALDES
Title or Position: C.E.O.
Credential:
Phone: 619-732-3060