Healthcare Provider Details

I. General information

NPI: 1104614775
Provider Name (Legal Business Name): ONE CREDIT SOLUTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 MURILLO DR
STOCKTON CA
95207-2226
US

IV. Provider business mailing address

429 MURILLO DR
STOCKTON CA
95207-2226
US

V. Phone/Fax

Practice location:
  • Phone: 210-424-9811
  • Fax: 210-424-9811
Mailing address:
  • Phone: 888-651-3854
  • Fax: 210-424-9811

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: TRISTAN MIRELES
Title or Position: OWNER
Credential:
Phone: 888-651-3854