| NPI | 1093927949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALLEY A SAEKAN Owner 760-346-0649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA HA1065) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA HA6022) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2009-03-02 |