Healthcare Provider Details

I. General information

NPI: 1033047733
Provider Name (Legal Business Name): STRAIGHT LINE MEDICAL SUPPLIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1641 BURTON ST
SAN DIEGO CA
92111-7526
US

IV. Provider business mailing address

1641 BURTON ST
SAN DIEGO CA
92111-7526
US

V. Phone/Fax

Practice location:
  • Phone: 619-246-2695
  • Fax: 866-495-7693
Mailing address:
  • Phone: 619-246-2695
  • Fax: 866-495-7693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE GONZALES
Title or Position: OWNER
Credential:
Phone: 619-246-2695