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General NPI Number Information
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NPI Number | 1538980479
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Entity Type | Organization
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Legal Business Name | DELUXE MEDICAL SUPPLY, LLC
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 2401 HIGHLAND AVENUE SUITE 108
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City | NATIONAL CITY
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State | CA
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Zip | 91950-7071
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Country | US
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Telephone | 619-741-5901
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Fax | 619-741-5910
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Provider Business Mailing Address
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Address Line | 7474 EL CAJON BLVD
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City | LA MESA
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State | CA
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Zip | 91942-7420
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Country | US
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Telephone | 619-741-5901
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Fax | 619-741-5910
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. YERKEN TENIZBAYEV
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Credential |
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Telephone | 619-550-7321
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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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