Healthcare Provider Details
I. General information
NPI: 1720215692
Provider Name (Legal Business Name): OCULUS INNOVATIVE SCIENCES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2009
Last Update Date: 06/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1129 N MCDOWELL BLVD
PETALUMA CA
94954-1110
US
IV. Provider business mailing address
1129 N MCDOWELL BLVD
PETALUMA CA
94954-1110
US
V. Phone/Fax
- Phone: 707-283-0550
- Fax:
- Phone: 707-283-0550
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
HOJABR
ALIMI
Title or Position: CEO/PRESIDENT
Credential: BS
Phone: 707-283-0550