Healthcare Provider Details

I. General information

NPI: 1962689026
Provider Name (Legal Business Name): ACCESS MEDICAL SUPPLIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 01/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 IRVING ST STE 104
SAN FRANCISCO CA
94122-2206
US

IV. Provider business mailing address

919 IRVING ST STE 104
SAN FRANCISCO CA
94122-2206
US

V. Phone/Fax

Practice location:
  • Phone: 415-681-5000
  • Fax: 415-704-3360
Mailing address:
  • Phone: 415-681-5000
  • Fax: 415-704-3360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number45062
License Number StateCA

VIII. Authorized Official

Name: MR. FRANCISCO BAUTISTA
Title or Position: DIRECTOR
Credential:
Phone: 415-681-5000