San Joaquin Orthotics & Prosthetics

LBN: San Joaquin Orthotics & Prosthetics
San Joaquin Orthotics & Prosthetics is an health care organization with primary practice located at 2211 N California St , Stockton CA 95204-5503. The organization recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as the primary health care specialty. San Joaquin Orthotics & Prosthetics can be contacted via phone (209) 932-0170, or through Evans, Matthew Shane via phone (209) 932-0170.

Contact Information

Primary practice address
2211 N California St Stockton CA 95204-5503
Phone: (209) 932-0170
Fax: (209) 932-0172
Website:
Map and Directions
Authorized official contact:
Name: Evans, Matthew Shane CPO
Phone: (209) 932-0170

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X 07-00072230 California

Profile Details

NPI number 1649290107
LBN Legal business name San Joaquin Orthotics & Prosthetics
DBA Doing business as
Authorized official Evans, Matthew Shane CPO
Entity Organization
Organization subpart 1 No
Enumeration date Jul 20th, 2006
Last updated Sep 15th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649290107 NPPES
California Other ZZZ07247Z BLUE SHIELD

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