Provider Demographics
NPI:1588043517
Name:BUDDYGUARD CORPORATION
Entity Type:Organization
Organization Name:BUDDYGUARD CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-987-4700
Mailing Address - Street 1:8800 NEWCASTLE AVE
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:91325-3135
Mailing Address - Country:US
Mailing Address - Phone:818-987-4700
Mailing Address - Fax:818-725-1559
Practice Address - Street 1:8800 NEWCASTLE AVE
Practice Address - Street 2:
Practice Address - City:SHERWOOD FOREST
Practice Address - State:CA
Practice Address - Zip Code:91325-3135
Practice Address - Country:US
Practice Address - Phone:818-987-4700
Practice Address - Fax:818-725-1559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies