| NPI | 1639789779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHIA SEAN Director 213-383-9212 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 222Z00000X Orthotist |
| 224900000X Mastectomy Fitter | |
| 224P00000X Prosthetist | |
| 225000000X Orthotic Fitter | |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2020-08-04 |