Provider Demographics
NPI:1871690016
Name:AABLE MEDICAL
Entity Type:Organization
Organization Name:AABLE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:RECALDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-738-1223
Mailing Address - Street 1:2309 PALMETTO AVE
Mailing Address - Street 2:B1
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-2736
Mailing Address - Country:US
Mailing Address - Phone:650-738-1223
Mailing Address - Fax:650-738-0818
Practice Address - Street 1:2309 PALMETTO AVE
Practice Address - Street 2:B1
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-2736
Practice Address - Country:US
Practice Address - Phone:650-738-1223
Practice Address - Fax:650-738-0818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101305332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME01104FMedicaid
CA5666540001Medicare NSC