| NPI | 1114043668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE VIVIENNE WEAVER Owner 858-793-6727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: CA 101242) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |