| NPI | 1417125568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE ANGELINE Regulatory Compliance Analyst 714-961-2102 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2016-10-07 |