MCCULLOCH'S WIDE SHOES
NPI 1790859585
Durable Medical Equipment & Medical Supplies in Brea, CA

Q: What is Jack G Mcculloch Jr's NPI number?

The NPI number for Jack G Mcculloch Jr is 1790859585. It was assigned to this organization in the NPPES registry on November 20, 2006. The provider is doing business as Mcculloch's Wide Shoes.

Q: What is Jack G Mcculloch Jr's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Active since November 20, 2006

685 S BREA BLVD, BREA, CA 92821(714) 529-6399(714) 529-2859 Get Directions Write a Review

NPPES record last updated: April 11, 2013. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Mcculloch's Wide Shoes NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MCCULLOCH'S WIDE SHOES (NPI 1790859585) is a healthcare organization registered as a durable medical equipment & medical supplies in Brea, California and active in the NPI registry since November 2006. The organization lists Apryl H Mcculloch, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1790859585

Entity TypeOrganization

Primary Taxonomy332B00000X

Legal Business NameJACK G MCCULLOCH JR

Location Address685 S BREA BLVDBrea, CA 92821-5308

Mailing Address685 S Brea BlvdBrea, CA 92821-5308 · (714) 529-6399 · Fax (714) 529-2859

Phone(714) 529-6399

Fax(714) 529-2859

Organization SubpartNo

Authorized OfficialApryl H MccullochCo-owner · (714) 529-6399

Enumeration DateNovember 20, 2006

Last NPPES UpdateApril 11, 2013

✔ NPI 1790859585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers

Taxonomy Code332B00000X

Definition

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.

685 S BREA BLVD, Brea, CA 92821

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Other Names 1

Doing Business AsMcculloch's Wide Shoes

Other Identifiers 1

Medicare NSC4808450001CA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack G Mcculloch Jr's NPI number?

The NPI number for Jack G Mcculloch Jr is 1790859585. It was assigned to this organization in the NPPES registry on November 20, 2006. The provider is doing business as Mcculloch's Wide Shoes.

Where is Jack G Mcculloch Jr located?

Jack G Mcculloch Jr is located at 685 S Brea Blvd, Brea, CA 92821. The listed phone number is (714) 529-6399.

What is Jack G Mcculloch Jr's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

When was this NPI record last updated?

The NPPES record for Jack G Mcculloch Jr was last updated on April 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.