Healthcare Provider Details
I. General information
NPI: 1538220587
Provider Name (Legal Business Name): HANGER PROSTHETICS & ORTHOTICS WEST INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6403 COYLE AVE SUITE 380
CARMICHAEL CA
95608-0311
US
IV. Provider business mailing address
6403 COYLE AVE SUITE 380
CARMICHAEL CA
95608-0311
US
V. Phone/Fax
- Phone: 916-536-1121
- Fax:
- Phone: 916-536-1121
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHERYL
PRICE
Title or Position: DIR OF REIMBURSEMENT
Credential:
Phone: 503-493-8288