MEDICARE: ASHLEY MEDICAL, 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	332BX2000X	Oxygen Equipment & Supplies (DME)	100357	CA

General Provider Information

NPI Number	:	1295733947
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHLEY MEDICAL, INC

Provider Business Mailing Address
First Line	:	1010 UNIVERSITY AVE
Second Line	:	PMB 503
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-3398
Country	:	US
Telephone Number	:	619-297-1983
Fax Number	:	619-297-6530

Provider Business Practice Location Address
First Line	:	1515 WASHINGTON ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-2421
Country	:	US
Telephone Number	:	619-297-1983
Fax Number	:	619-297-6530

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. CAROL ANNE ASHLEY
Credential	:	RRT, RCP
Telephone Number	:	619-297-1983

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/22/2020

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