PACIFIC SURGICAL CORP. NPI 1922465087

NPI Information

  • NPI: 1922465087
  • Provider Name: PACIFIC SURGICAL CORP.
  • Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
  • Entity Type: Organization
  • Former Legal Business Name: PACIFIC SURGICAL LLC
  • Address: 1110 W. KETTLEMAN LN.
    SUITE 21
    LODI, CA
    ZIP 95240
  • Phone: (209) 329-6443

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NPI Details

PACIFIC SURGICAL CORP. is a durable medical equipment medical supplies in Lodi, CA. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. PACIFIC SURGICAL CORP. NPI is 1922465087. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Pacific Surgical Llc.

The provider's business location address is:

1110 W. KETTLEMAN LN.
SUITE 21
LODI, CA
ZIP 95240-047
Phone: (209) 329-6443
Fax: (209) 365-6383

The provider's authorized official is Brian Eugene Whatley .
The authorized official title is Ceo/principle Owner and has the following contact phone number (916) 548-1880.

The enumeration date for this NPI number is 1/20/2016 and was last updated on 1/20/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesKH102259891CALIFORNIAYes

What is NPI?

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This page was last updated on: 11/21/2025

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