Healthcare Provider Details

I. General information

NPI: 1376568162
Provider Name (Legal Business Name): HUMAN DESIGNS PROSTHETIC AND ORTHOTIC LABORATORY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 12/17/2020
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 E FOOTHILL BLVD
ARCADIA CA
91006-2307
US

IV. Provider business mailing address

49 E FOOTHILL BLVD
ARCADIA CA
91006-2307
US

V. Phone/Fax

Practice location:
  • Phone: 626-445-7797
  • Fax: 626-445-7873
Mailing address:
  • Phone: 626-445-7797
  • Fax: 626-445-7873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. RONALD MERRITT
Title or Position: PRESIDENT
Credential: CPO
Phone: 626-445-7797