Provider Demographics
NPI:1205311479
Name:METICULOUS MEDICAL, INC.
Entity type:Organization
Organization Name:METICULOUS MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:JERRY
Authorized Official - Last Name:MCCAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, ATC
Authorized Official - Phone:559-593-2451
Mailing Address - Street 1:672 WEST 11TH STREET
Mailing Address - Street 2:SUITE 323
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376
Mailing Address - Country:US
Mailing Address - Phone:833-638-6331
Mailing Address - Fax:559-453-0107
Practice Address - Street 1:672 WEST 11TH STREET
Practice Address - Street 2:SUITE 323
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376
Practice Address - Country:US
Practice Address - Phone:833-638-6331
Practice Address - Fax:559-453-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA98717OtherHOME MEDICAL DEVICE DETAIL LICENSE