Provider Demographics
NPI:1568847614
Name:SAN DIEGO TECH INC.
Entity Type:Organization
Organization Name:SAN DIEGO TECH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ARREOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-571-0697
Mailing Address - Street 1:5519 CLAIREMONT MESA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-2342
Mailing Address - Country:US
Mailing Address - Phone:619-571-0697
Mailing Address - Fax:619-330-4921
Practice Address - Street 1:7822 CONVOY CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1210
Practice Address - Country:US
Practice Address - Phone:619-571-0697
Practice Address - Fax:619-330-4921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2007026987332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies