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General NPI Number Information
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NPI Number | 1225509912
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Entity Type | Organization
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Legal Business Name | RANCHO BERNARDO MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 12/06/2018
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Last Update Date | 05/15/2019
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Provider Practice Location Address
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Address Line | 16766 BERNARDO CENTER DR STE 104
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City | SAN DIEGO
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State | CA
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Zip | 92128-2501
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Country | US
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Telephone | 858-943-4812
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Fax | 858-924-8489
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Provider Business Mailing Address
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Address Line | 16766 BERNARDO CENTER DR STE 104
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City | SAN DIEGO
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State | CA
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Zip | 92128-2501
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Country | US
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Telephone | 858-924-8489
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZAINA DADAH
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Credential |
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Telephone | 949-331-6003
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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 |
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License Number State |
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