Provider Demographics
NPI:1871368746
Name:PEAQ MEDICAL LLC
Entity type:Organization
Organization Name:PEAQ MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SABRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-369-1921
Mailing Address - Street 1:230 GODDARD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4625
Mailing Address - Country:US
Mailing Address - Phone:949-850-8585
Mailing Address - Fax:
Practice Address - Street 1:230 GODDARD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4625
Practice Address - Country:US
Practice Address - Phone:949-850-8585
Practice Address - Fax:949-850-8586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies