Healthcare Provider Details

I. General information

NPI: 1407202120
Provider Name (Legal Business Name): FLEXIMUG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 MARKET ST # 400
SAN DIEGO CA
92101-7233
US

IV. Provider business mailing address

1041 MARKET ST # 400
SAN DIEGO CA
92101-7233
US

V. Phone/Fax

Practice location:
  • Phone: 562-841-3165
  • Fax:
Mailing address:
  • Phone: 800-588-6190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number102-775138
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number102-775138
License Number StateCA

VIII. Authorized Official

Name: MR. WILLIAM DAVID CARDELL JR.
Title or Position: CEO
Credential: MBA
Phone: 800-588-6190