Provider Demographics
NPI:1871735258
Name:TOBII ASSISTIVE TECHNOLOGY, INC
Entity type:Organization
Organization Name:TOBII ASSISTIVE TECHNOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & COO
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDNICKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-461-8200
Mailing Address - Street 1:11219 MORANDA CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4086
Mailing Address - Country:US
Mailing Address - Phone:858-679-9538
Mailing Address - Fax:858-679-9539
Practice Address - Street 1:11219 MORANDA CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-4086
Practice Address - Country:US
Practice Address - Phone:858-679-9538
Practice Address - Fax:858-679-9539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2107836332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME02503FMedicaid