| NPI | 1720573496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE ANGELINE Reg Compliance Specialist Iv 714-961-2102 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2022-02-25 |