Sole Proprietor

LBN: Carlos Valenzuela
Sole Proprietor is an health care organization with primary practice located at 4224 Ohio St , San Diego CA 92104-1320. The organization recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as the primary health care specialty. Carlos Valenzuela can be contacted via phone (619) 280-9174, or through Valenzuela, Carlos via phone (619) 280-9174.

Contact Information

Primary practice address
4224 Ohio St San Diego CA 92104-1320
Fax: (619) 280-9286
Website:
Authorized official contact:
Name: Valenzuela, Carlos

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X

Profile Details

NPI number 1508876442
LBN Legal business name Carlos Valenzuela
DBA Doing business as Sole Proprietor
Authorized official Valenzuela, Carlos
Entity Organization
Organization subpart 1 No
Enumeration date Aug 9th, 2006
Last updated Sep 9th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508876442 NPPES
California MEDICAID GC000680

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