Healthcare Provider Details

I. General information

NPI: 1356457345
Provider Name (Legal Business Name): BEST FRIENDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 MORRO BAY BLVD
MORRO BAY CA
93442-2144
US

IV. Provider business mailing address

615 SANTA LUCIA AVE
LOS OSOS CA
93402-1127
US

V. Phone/Fax

Practice location:
  • Phone: 805-772-2002
  • Fax:
Mailing address:
  • Phone: 805-528-4334
  • Fax: 805-528-4533

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. DAN R DORIS
Title or Position: OWNER
Credential:
Phone: 805-528-4334