MEDICARE: BAY AREA DME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1093960866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY AREA DME

Provider Business Mailing Address
First Line	:	4061 E CASTRO VALLEY BLVD
Second Line	:	#414
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94552-4840
Country	:	US
Telephone Number	:	714-683-4606
Fax Number	:	877-408-9985

Provider Business Practice Location Address
First Line	:	18711 BRICKELL WAY
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94546-2407
Country	:	US
Telephone Number	:	714-683-4606
Fax Number	:	877-408-9985

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NATALIE GALLEGOS
Credential	:
Telephone Number	:	714-683-4606

Provider Enumeration Date	:	11/20/2008
Last Update Date	:	11/20/2008

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