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General NPI Number Information
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NPI Number | 1215297593
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Entity Type | Organization
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Legal Business Name | US SPECIALITY LABS INC
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 05/21/2012
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Provider Practice Location Address
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Address Line | 11578 SORRENTO VALLEY RD SUITE 25/26
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City | SAN DIEGO
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State | CA
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Zip | 92121-1311
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Country | US
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Telephone | 858-481-5031
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Fax |
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Provider Business Mailing Address
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Address Line | 11578 SORRENTO VALLEY RD SUITE 25/26
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City | SAN DIEGO
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State | CA
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Zip | 92121-1311
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Country | US
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Telephone | 858-481-5031
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TIM R DRAPEAU
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Credential |
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Telephone | 858-481-5031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | B2011015790
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License Number State | CA
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