MEDICARE: GO2MEDICAL MANAGEMENT SERVICES, INC.

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	251E00000X	Home Health Agency	BL-1255142	CA

General Provider Information

NPI Number	:	1114332525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GO2MEDICAL MANAGEMENT SERVICES, INC.

Provider Business Mailing Address
First Line	:	2003 S. EL CAMINO REAL
Second Line	:	STE. 204
City	:	OCEANSIDE
State	:	CA
Zip	:	92054
Country	:	US
Telephone Number	:	888-405-2505
Fax Number	:	888-316-3027

Provider Business Practice Location Address
First Line	:	2003 S EL CAMINO REAL
Second Line	:	STE. 204
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6214
Country	:	US
Telephone Number	:	888-405-2505
Fax Number	:	888-316-3027

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	FRANK RODRIGUEZ
Credential	:
Telephone Number	:	760-554-1963

Provider Enumeration Date	:	06/24/2014
Last Update Date	:	06/24/2014

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