| NPI | 1205583606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK DJABOURIAN Owner 626-858-9460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 225000000X Orthotic Fitter |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 222Z00000X Orthotist | |
| 224L00000X | |
| 224P00000X Prosthetist | |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2022-03-08 |