| NPI | 1255842092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNESTINA SMITH Compliance Officer 949-382-3919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2018-03-15 |