NPI | 1326379736 |
---|---|
Entity Type | Organization |
Authorized Contact | GRACE ANGELINE Provider Contract Analyst Iii 714-961-2102 |
Organization Subpart ? | Yes |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 101319) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2010-01-25 |
Last Update Date | 2024-09-20 |