Healthcare Provider Details

I. General information

NPI: 1588949275
Provider Name (Legal Business Name): PERSUE HEALTH PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 10/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 S BRISTOL ST 218 203
SANTA ANA CA
92704-6209
US

IV. Provider business mailing address

2740 S BRISTOL ST 218 203
SANTA ANA CA
92704-6209
US

V. Phone/Fax

Practice location:
  • Phone: 714-754-8200
  • Fax: 714-754-8201
Mailing address:
  • Phone: 714-754-8200
  • Fax: 714-754-8201

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: MR. ROBERTO GOMEZ JR.
Title or Position: PARTNERSHIP
Credential:
Phone: 714-754-8200