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General NPI Number Information
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NPI Number | 1659685386
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Entity Type | Organization
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Legal Business Name | IMPEDIMED INC
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Dates
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Enumeration Date | 08/05/2010
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 5959 CORNERSTONE CT W STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92121-3764
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Country | US
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Telephone | 858-412-0200
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Fax | 858-558-8540
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Provider Business Mailing Address
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Address Line | 5959 CORNERSTONE CT W STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92121-3764
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Country | US
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Telephone | 858-412-0200
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Fax | 858-558-8540
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT GLOBAL OPS
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Name | MR. JOHN SIPES HONEYCUTT
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Credential | BSME
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Telephone | 858-412-0200
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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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