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General NPI Number Information
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NPI Number | 1932435831
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Entity Type | Organization
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Legal Business Name | PACIFIC BEACH SCOOTERS, LLC
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Dates
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Enumeration Date | 10/27/2009
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Last Update Date | 10/27/2009
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Provider Practice Location Address
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Address Line | 2280 GARNET AVE SUITE 101
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City | SAN DIEGO
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State | CA
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Zip | 92109-3775
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Country | US
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Telephone | 858-272-3717
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Fax | 858-272-3737
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Provider Business Mailing Address
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Address Line | 2280 GARNET AVE SUITE 101
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City | SAN DIEGO
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State | CA
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Zip | 92109-3775
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Country | US
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Telephone | 858-272-3717
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Fax | 858-272-3737
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Authorized Official
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Title or Position | MANAGER/MEMBER
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Name | MS. CHRISTINA DELANEY
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Credential |
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Telephone | 858-272-3717
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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 | 101-244982
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License Number State | CA
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