Healthcare Provider Details

I. General information

NPI: 1174543912
Provider Name (Legal Business Name): XTREME MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49744 GORMAN POST RD 4
GORMAN CA
93243-9701
US

IV. Provider business mailing address

PO BOX 68
GORMAN CA
93243-0068
US

V. Phone/Fax

Practice location:
  • Phone: 661-248-6260
  • Fax: 661-248-6270
Mailing address:
  • Phone: 661-248-6260
  • Fax: 661-248-6270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. BART SALGADO
Title or Position: PRESIDENT
Credential:
Phone: 562-803-9444