| NPI | 1508397514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN DJABOURIAN Pedorthist/Owner 626-858-9460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224L00000X |
| Additional Taxonomies | 222Z00000X Orthotist |
| 224P00000X Prosthetist | |
| 225000000X Orthotic Fitter | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-22 |