| NPI | 1811259856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD B EVANS President 619-460-0714 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 31914) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CA 31914) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: CA 31914) | |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-06-14 |