=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386780062
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VALLEY OXYGEN LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2007
-----------------------------------------------------
Last Update Date | 08/01/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1370 TULLY RD STE 507
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95122-3056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-262-1720
-----------------------------------------------------
Fax | 408-262-1721
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1240 MOUNTAIN VIEW ALVISO RD STE D
-----------------------------------------------------
City | SUNNYVALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94089-2239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-262-1720
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT & CEO
-----------------------------------------------------
Name | DANIEL LUNA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 661-589-6800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number | 43734
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------