Provider Demographics
NPI:1811245020
Name:PULMOCARE RESPIRATORY SERVICES INC.
Entity type:Organization
Organization Name:PULMOCARE RESPIRATORY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GINGLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-777-5000
Mailing Address - Street 1:760 VIA LATA
Mailing Address - Street 2:100
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-3977
Mailing Address - Country:US
Mailing Address - Phone:909-777-5000
Mailing Address - Fax:909-777-5005
Practice Address - Street 1:9353 ACTIVITY RD
Practice Address - Street 2:F
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4412
Practice Address - Country:US
Practice Address - Phone:909-777-5000
Practice Address - Fax:909-777-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1291650001Medicare UPIN