Provider Demographics
NPI:1982221768
Name:EQUIP HEALTH MEDICAL, PC
Entity Type:Organization
Organization Name:EQUIP HEALTH MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLIENT OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CAITLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEFIORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-340-1419
Mailing Address - Street 1:PO BOX 131747
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92013-1747
Mailing Address - Country:US
Mailing Address - Phone:619-350-6290
Mailing Address - Fax:619-436-4739
Practice Address - Street 1:2659 STATE ST STE 100
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1627
Practice Address - Country:US
Practice Address - Phone:855-387-4378
Practice Address - Fax:760-683-6585
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EQUIP HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-29
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty