Healthcare Provider Details

I. General information

NPI: 1982772034
Provider Name (Legal Business Name): PRO-TECH MEDICAL EQUIPMENT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 03/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42210 ROICK DR SUITE 12
TEMECULA CA
92590-5523
US

IV. Provider business mailing address

42210 ROICK DR SUITE 12
TEMECULA CA
92590-5523
US

V. Phone/Fax

Practice location:
  • Phone: 951-296-6600
  • Fax: 951-296-6609
Mailing address:
  • Phone: 951-296-6600
  • Fax: 951-296-6609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierDME00539F
Identifier TypeMEDICAID
Identifier StateCA
Identifier Issuer

VIII. Authorized Official

Name: MR. DENNIS M. D'ANTIN
Title or Position: PRESIDENT
Credential:
Phone: 951-296-6600