Provider Demographics
NPI:1518107804
Name:THREE WISHES, INC.
Entity Type:Organization
Organization Name:THREE WISHES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-891-0418
Mailing Address - Street 1:21184 FIGUEROA ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-1938
Mailing Address - Country:US
Mailing Address - Phone:760-891-0418
Mailing Address - Fax:760-891-0429
Practice Address - Street 1:43084 RANCHO WAY
Practice Address - Street 2:SUITE B
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3487
Practice Address - Country:US
Practice Address - Phone:951-694-8769
Practice Address - Fax:951-694-8708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies