Healthcare Provider Details

I. General information

NPI: 1962880013
Provider Name (Legal Business Name): RESP-A-SURE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2015
Last Update Date: 05/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 E GUASTI RD SUITE NUMBER 100
ONTARIO CA
91761-8660
US

IV. Provider business mailing address

3200 E GUASTI RD SUITE NUMBER 100
ONTARIO CA
91761-8660
US

V. Phone/Fax

Practice location:
  • Phone: 909-821-5111
  • Fax: 909-986-2545
Mailing address:
  • Phone: 909-821-5111
  • Fax: 909-986-2545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number26804
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2278E1000X
TaxonomyEducational Certified Respiratory Therapist
License Number26804
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2278G0305X
TaxonomyGeriatric Care Certified Respiratory Therapist
License Number26804
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2278G1100X
TaxonomyGeneral Care Certified Respiratory Therapist
License Number26804
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2278H0200X
TaxonomyHome Health Certified Respiratory Therapist
License Number26804
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code2278P1005X
TaxonomyPulmonary Rehabilitation Certified Respiratory Therapist
License Number26804
License Number StateCA

VIII. Authorized Official

Name: MR. BURNEY BERNARD IRVIN IV
Title or Position: PRESIDENT /CEO
Credential: RCP
Phone: 909-821-5111