| NPI | 1467824375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE ANGELINE Reg Compliance Specialist Iii 714-961-2102 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: PA 6000008807) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2022-01-10 |