SOURCE ONE MEDICAL INC (NPI# 1619972239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619972239 |
| Entity Type | Organization |
| Organization Name | SOURCE ONE MEDICAL INC |
| Other Organization Name | SOURCE ONE MEDICAL INC |
| Practice Address |
16 Technology Dr Suite 165 Irvine CA 92618-2328 |
| Mailing Address |
16 Technology Dr Suite165 Irvine CA 92618-2328 |
| Practice Telephone | 8884479056 |
| Practice Fax Number | 9493876371 |
| Mailing Telephone | 8884479056 |
| Mailing Fax Number | 9493876371 |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2012-05-14 |
| Authorized Official Name | DENNIS KLINE (PRESIDENT/CEO) |
| Authorized Official Telephone | 8884479056 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
103616 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Source One Medical Inc | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679736888 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 6280 S Valley View Blvd, Suite 220, Las Vegas, NV 89118-3809 | 2008-07-08 |
| 1568653871 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 38 Tesla, Suite 150, Irvine, CA 92618-4669 | 2007-08-05 |
| 1679661870 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 1397 Piedmont Dr, Ste 300, Troy, MI 48083-1906 | 2006-10-11 |
| 1578672374 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 7551 W 99th St, Bridgeview, IL 60455-2403 | 2006-08-29 |
| 1881703684 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 2124 S 156th Cir, Omaha, NE 68130-2503 | 2006-08-29 |
| 1982673257 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 6886 Hillsdale Ct, Indianapolis, IN 46250-2001 | 2006-03-17 |
| 1043289176 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 411 Ironwood Dr, Salt Lake City, UT 84115-2948 | 2006-03-14 |
| 1275530784 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 96 Inverness Dr E, Unit D, Englewood, CO 80112-5302 | 2005-06-30 |
| 1750388252 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 2121 New Market Pkwy Se, Suite 108, Marietta, GA 30067-9315 | 2005-06-30 |
| 1548416043 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 7551 W 99th St, Bridgeview, IL 60455-2403 | 2008-08-15 |
| Street Address |
16 TECHNOLOGY DR SUITE 165 |
| City | IRVINE |
| State | CA |
| Zip Code | 92618-2328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477817559 | Center for Social Cognition | Marriage & Family Therapist | 16 Technology Dr, Suite 100, Irvine, CA 92618-2355 | 2012-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558982306 | Zermina Akbary | Registered Nurse | 131 Theme, Irvine, Irvine, CA 92618 | 2020-05-04 |
| 1760028575 | Leibow Psychology Group, PC | Counselor | 7725 Gateway #4203, Irvine, CA 92618 | 2019-11-27 |
| 1790263713 | Jw Professional Dental Corporation | Dentist | 14785 Jeffrey Rd. Ste 200, Irvine, CA 92618 | 2018-08-01 |
| 1093200610 | Kevin Dinh Trinh, Md Inc. | Anesthesiology | 100 Fieldwood, Irvine, CA 92618 | 2018-06-26 |
| 1952899221 | Oneness Health Group Inc | Chiropractor | 25 Deergrass, Irvine, CA 92618 | 2018-04-23 |
| 1144738899 | Morvarid Emamy | Dentist | 23448 Spectrum, Irvine, CA 92618 | 2018-01-16 |
| 1083123194 | Ning Wang | Behavioral Analyst | 9844 Research Dr Ste 100, Irvine, CA 92618 | 2017-09-21 |
| 1043679715 | Dent All By Dr. Z | Dentist | 15362 Alton Parkway, Irvine, CA 92618 | 2016-02-23 |
| 1265897862 | Whitney Elyse Davies | Physical Therapist | 26650 Alton Parkway, Irvine, CA 92618 | 2015-12-23 |
| 1245619295 | Nora Witt | Registered Nurse | 16205 Sand Canyon Avenue, Suite 100, Irvine, CA 92618 | 2015-05-22 |
| Find all providers in zip 92618 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992154983 | Tom Gonzalez Dental Corporation | Durable Medical Equipment & Medical Supplies | 113 Waterworks Way Ste 220, Irvine, CA 92618-3176 | 2016-06-09 |
| 1568653871 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 38 Tesla, Suite 150, Irvine, CA 92618-4669 | 2007-08-05 |
| 1437448289 | Thomas Gonzales Dental Corp | Durable Medical Equipment & Medical Supplies | 113 Waterworks Way, Suite 220, Irvine, CA 92618-3167 | 2011-04-01 |
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| 1225659873 | I2b Networks, Inc | Durable Medical Equipment & Medical Supplies | 8830 Complex Dr, San Diego, CA 92123-1404 | 2020-05-05 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.