Healthcare Provider Details

I. General information

NPI: 1366931388
Provider Name (Legal Business Name): MEDICAL BIOWASTE SOLUTIONS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2018
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25971 PALA
MISSION VIEJO CA
92691-2727
US

IV. Provider business mailing address

25971 PALA
MISSION VIEJO CA
92691-2727
US

V. Phone/Fax

Practice location:
  • Phone: 949-452-0794
  • Fax: 949-203-0458
Mailing address:
  • Phone: 949-452-0794
  • Fax: 949-203-0458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MR. JUAN CRUZ MANZOTTI
Title or Position: ACCOUNT EXECUTIVE
Credential:
Phone: 949-282-4808