Provider Demographics
NPI:1891787594
Name:BREG, INC.
Entity Type:Organization
Organization Name:BREG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-795-5440
Mailing Address - Street 1:2382 FARADAY AVENUE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-7220
Mailing Address - Country:US
Mailing Address - Phone:760-795-5440
Mailing Address - Fax:
Practice Address - Street 1:2382 FARADAY AVENUE
Practice Address - Street 2:SUITE 300
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7220
Practice Address - Country:US
Practice Address - Phone:760-795-5440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WATER STREET
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-18
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0662650001Medicare NSC