Healthcare Provider Details

I. General information

NPI: 1235310699
Provider Name (Legal Business Name): VISIONQUEST INDUSTRIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 DECISION ST STE A
VISTA CA
92081-8578
US

IV. Provider business mailing address

1390 DECISION ST STE A
VISTA CA
92081-8578
US

V. Phone/Fax

Practice location:
  • Phone: 949-261-3000
  • Fax: 888-266-6968
Mailing address:
  • Phone: 800-266-6969
  • Fax: 888-266-6968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number101923
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number101923
License Number StateCA

VIII. Authorized Official

Name: RICHARD ROY HUFF
Title or Position: VICE PRESIDENT REIMBURSEMENT
Credential:
Phone: 949-794-3440