Healthcare Provider Details

I. General information

NPI: 1881855393
Provider Name (Legal Business Name): VISION QUEST INDUSTRIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 DECISION ST SUITE A
VISTA CA
92081-8523
US

IV. Provider business mailing address

3187 RED HILL AVE STE 150
COSTA MESA CA
92626-3449
US

V. Phone/Fax

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