MEDICARE: BALEHR MEDICAL DEVICES 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	332B00000X	Durable Medical Equipment & Medical Supplies		CA

General Provider Information

NPI Number	:	1174802177
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALEHR MEDICAL DEVICES INC.

Provider Business Mailing Address
First Line	:	9230 REAGAN RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-2109
Country	:	US
Telephone Number	:	619-792-3757
Fax Number	:	800-801-7062

Provider Business Practice Location Address
First Line	:	9230 REAGAN RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-2109
Country	:	US
Telephone Number	:	619-792-3757
Fax Number	:	800-801-7062

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BJ RETUYA
Credential	:
Telephone Number	:	619-792-3757

Provider Enumeration Date	:	08/08/2011
Last Update Date	:	06/12/2013

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