Healthcare Provider Details

I. General information

NPI: 1740512748
Provider Name (Legal Business Name): ABUNDANT HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2010
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 E VALLEY PKWY #100
ESCONDIDO CA
92025-3433
US

IV. Provider business mailing address

941 E VALLEY PKWY #100
ESCONDIDO CA
92025-3433
US

V. Phone/Fax

Practice location:
  • Phone: 760-746-2331
  • Fax: 760-746-9729
Mailing address:
  • Phone: 760-746-2331
  • Fax: 760-746-9729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL ANDREW BERNOU
Title or Position: PRESIDENT
Credential:
Phone: 760-746-2331