Famous Foam

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

FAMOUS FOAM

Practice address

2397 San Pablo Ave
Berkeley, CA 94702-2055

Phone

(510) 841-9001

NPI assigned

Oct 3, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Bradshaw

Title

Owner

Phone

(415) 491-4799

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1831473313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MOUNT WHITNEY DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031037",
            "telephone_number": "415-491-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2397 SAN PABLO AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947022055",
            "telephone_number": "510-841-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMOUS FOAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-03",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "BRADSHAW",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-491-4799"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Customized Equipment (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.