Healthcare Provider Details

I. General information

NPI: 1205060423
Provider Name (Legal Business Name): METIS PRODUCTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2009
Last Update Date: 05/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4186 SORRENTO VALLEY BLVD STE. J
SAN DIEGO CA
92121-1414
US

IV. Provider business mailing address

PO BOX 910844
SAN DIEGO CA
92191-0844
US

V. Phone/Fax

Practice location:
  • Phone: 858-736-5400
  • Fax:
Mailing address:
  • Phone: 858-736-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES PANTERA
Title or Position: GENERAL MANAGER
Credential: MBA, PMP, PA-C
Phone: 858-736-5400