Organization · Type 2 NPI
Source One Medical Inc
Customized Equipment (DME) · Irvine, CA
NPI number
1619972239
Active
Practice location
16 Technology Dr, Suite 165
Irvine, CA 92618-2328
Fax (949) 387-6371
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Customized Equipment (DME) Primary | 332BC3200X | 103616 (CA) |
Customized Equipment (DME): Definition to come...
5 other providers at this address
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- Kendall Marina DoBehavior Analyst Irvine, CA NPI 1609764802
- Sanam ChawlaBehavior Analyst Irvine, CA NPI 1841188059
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About NPI 1619972239
Source One Medical Inc's National Provider Identifier is 1619972239, issued on Jun 20, 2005. The primary taxonomy on file is Customized Equipment (DME) (332BC3200X), and the practice location is in Irvine, CA. The record was last updated on May 14, 2012.