Healthcare Provider Details
I. General information
NPI: 1336758408
Provider Name (Legal Business Name): SHARP REES-STEALY MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/24/2020
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8701 CUYAMACA ST
SANTEE CA
92071
US
IV. Provider business mailing address
PO BOX 939087
SAN DIEGO CA
92193-9087
US
V. Phone/Fax
- Phone: 858-499-2600
- Fax:
- Phone: 858-262-6344
- Fax: 858-636-2032
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALAN
BIER
Title or Position: PRESIDENT
Credential: MD
Phone: 858-262-6666