NPI | 1285708149 |
---|---|
Entity Type | Organization |
Authorized Contact | GRACE ANGELINE Provider Contract Analyst Iii 714-961-2102 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
Enumeration Date | 2006-11-20 |
Last Update Date | 2024-09-25 |