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General NPI Number Information
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NPI Number | 1407928054
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Entity Type | Organization
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Legal Business Name | PROHEALTH CARE, INC.
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1590 OAKLAND RD B 105
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City | SAN JOSE
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State | CA
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Zip | 95131-2443
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Country | US
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Telephone | 408-452-1658
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Fax | 408-452-7703
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Provider Business Mailing Address
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Address Line | 1590 OAKLAND RD B 105
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City | SAN JOSE
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State | CA
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Zip | 95131-2443
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Country | US
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Telephone | 408-452-1658
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Fax | 408-452-7703
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Authorized Official
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Title or Position | PRESIDENT
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Name | MALALAI MOHIDEEN
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Credential |
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Telephone | 408-452-1658
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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 | 44893
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License Number State | CA
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