Douglas P Ebbers | San Diego, CA • PECOS Search

Douglas P Ebbers

Specialist

Other Service Providers

3665 Kearny Villa Rd, Suite 405, San Diego, CA 92123-1953

PECOS Enrollment

Based on the most recent information from CMS, provider Douglas P Ebbers does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1861678633
Provider Type
Individual
Full Name
Ebbers, Douglas P
Credential
M.S. IN ED.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
1/11/2008
Last Updated
1/11/2008

Contact Information

Practice Location

3665 Kearny Villa Rd, Suite 405, San Diego, CA 92123-1953

Unlisted Fax

Mailing Location

3020 Children'S Way, Mc 5111, San Diego, CA 92123-4282

(858) 966-7521

Provider Taxonomies

Code	Description	License
Code 174400000X Primary	Description Specialist Other Service Providers	License Unlisted Issuer