NPI | 1992182562 |
---|---|
Entity Type | Organization |
Authorized Contact | GRACE ANGELINE Provider Contract Analyst Iii 714-961-2102 |
Organization Subpart ? | Yes |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2015-05-02 |
Last Update Date | 2024-02-15 |