Healthcare Provider Details

I. General information

NPI: 1114016896
Provider Name (Legal Business Name): THREE WISHES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43084 RANCHO WAY SUITE B
TEMECULA CA
92590-3487
US

IV. Provider business mailing address

2390 CRENSHAW BLVD #128
TORRANCE CA
90501-3300
US

V. Phone/Fax

Practice location:
  • Phone: 951-694-8708
  • Fax: 951-694-8769
Mailing address:
  • Phone: 800-535-3063
  • Fax: 800-270-8102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: DENNIS WILLIAM KARNES
Title or Position: PRESIDENT
Credential:
Phone: 800-535-3063