Healthcare Provider Details

I. General information

NPI: 1083894406
Provider Name (Legal Business Name): SPECIALIZED ORTHOPEDIC SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9259 ETON AVE
CHATSWORTH CA
91311-5808
US

IV. Provider business mailing address

14431 VENTURA BLVD STE 290
SHERMAN OAKS CA
91423-2606
US

V. Phone/Fax

Practice location:
  • Phone: 818-280-3147
  • Fax: 323-978-1922
Mailing address:
  • Phone: 818-280-3147
  • Fax: 323-978-2479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY VONDERHAAR
Title or Position: PRESIDENT / CEO
Credential:
Phone: 818-280-3147