| NPI | 1215035043 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | GRACE ANGELINE Regulatory Compliance Analyst Ii 714-961-2102  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier | 
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies | 
| Enumeration Date | 2006-09-20 | 
| Last Update Date | 2024-12-12 |