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General NPI Number Information
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NPI Number | 1356450423
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Entity Type | Organization
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Legal Business Name | GOLDEN VALLEY MEDICAL & OXYGEN SERVICE
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 424 W HIGHLAND AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92405-4014
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Country | US
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Telephone | 909-884-0445
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Fax | 909-882-6358
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Provider Business Mailing Address
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Address Line | 424 W HIGHLAND AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92405-4014
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Country | US
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Telephone | 909-884-0445
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Fax | 909-882-6358
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Authorized Official
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Title or Position | CEO /PRESIDENT
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Name | PATRICIA ANN BOBBITT
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Credential |
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Telephone | 909-884-0445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | M66550
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | M66550
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | M66550
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | M66550
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License Number State | CA
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