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Facility/Site <br /> Horizon Oxygen and Medical Equipment INC-Stockton CERS to i <br /> 079 Calloway Ct 10871833 <br /> Stockton,CA 95215 <br /> ubmittal Status + ': <br /> ubmitted on 5/27/2021 by Alfonso Trinidad of HORIZON OXYGEN AND MEDICAL EQUIPMENT INC(ANAHEIM,CA) <br /> Identification <br /> Chris Mlllarez Beginning Date Ending Date <br /> Aerator Phone Business Phone Business Fax <br /> 209)665-1739 (866)575-8901 (714)575-8989 Dun&Bradstreet SIC Code Primary NAILS <br /> 7352 446199 <br /> Facility/Site Mailing Address 3rimary Emergency Contact <br /> 079 E Calloway Ct. hris Millarez <br /> TOCKTON,CA 95215 Fill. L <br /> Branch Manager 'u <br /> ustness Phone 24-Hour Phone Pager Number <br /> 866)575-8901 (866)575 8907 <br /> caner econdary Emergency Contact <br /> Paul Huante lobert Martinez J <br /> 714)713-0129 ride <br /> 1837 N Neville St Northern Regional Manager <br /> range,CA 92865 3miness Phone 24-Hour Phone Pager Number <br /> 866)575-8901 (866)575-8901 (559)267 3203 <br /> Billing Contact Environmental Contact <br /> Barbara Piette NIfonso Trinidad <br /> 866)575-8901 ap@horizonoxygen.com 714)575-8901 atrinidad@horizonoxygen.com <br /> 1837 N Neville St 1837 N Neville St <br /> range,CA 92887 Drange,CA 92887 <br /> Name of Signer Signer Title Document Preparer I, <br /> Alfonso Trinidad VP of Client and Patient Service Alfonso Trinidad <br /> Additional Information <br /> Locally-collected Fields <br /> Some or all of the following fields maybe required by your local regulator(s). <br /> Property Owner Assessor Parcel Number(APN) <br /> om Fehr <br /> Number of Employees i. <br /> Phone <br /> (925)718-1201 8 <br /> Malling Address Facility ID kf4 <br /> 4 Alamo Square Suite 200 <br /> %Iamo,CA 94507 <br /> I <br /> Printed on 5/27/2021 6:49 PM <br />