Provider Demographics
NPI:1114043668
Name:PRESCRIBED OXYGEN INC
Entity Type:Organization
Organization Name:PRESCRIBED OXYGEN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:VIVIENNE
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-793-6727
Mailing Address - Street 1:7915 SILVERTON AVE
Mailing Address - Street 2:SUITE 314
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-6348
Mailing Address - Country:US
Mailing Address - Phone:858-793-6727
Mailing Address - Fax:858-509-0764
Practice Address - Street 1:7915 SILVERTON AVE
Practice Address - Street 2:SUITE 314
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-6348
Practice Address - Country:US
Practice Address - Phone:858-793-6727
Practice Address - Fax:858-509-0764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101242332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5235660001Medicare ID - Type Unspecified