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General NPI Number Information
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NPI Number | 1487746327
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Entity Type | Organization
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Legal Business Name | PEARL VENTURES
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 10/07/2019
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Provider Practice Location Address
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Address Line | 1012 E COOLEY DR STE N
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City | COLTON
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State | CA
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Zip | 92324-3949
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Country | US
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Telephone | 909-422-8005
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Fax | 909-824-1080
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Provider Business Mailing Address
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Address Line | 1012 E COOLEY DR STE N
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City | COLTON
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State | CA
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Zip | 92324-3949
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Country | US
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Telephone | 909-422-8005
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Fax | 909-824-1080
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Authorized Official
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Title or Position | MANAGER
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Name | MR. OFONIME UKPONG
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Credential |
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Telephone | 909-422-8005
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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 |
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License Number State |
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