| NPI | 1508911173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA ALEJANDRE Office Administrator 858-613-0958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: CA CPO1661) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: CA CO004434) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2019-09-26 |