Healthcare Provider Details

I. General information

NPI: 1356858864
Provider Name (Legal Business Name): ABI P&O INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2018
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 CHURCH AVE
CHULA VISTA CA
91910-2702
US

IV. Provider business mailing address

6190 FAIRMOUNT AVE STE A
SAN DIEGO CA
92120-3428
US

V. Phone/Fax

Practice location:
  • Phone: 619-425-8189
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: DIEGO MENDOZA
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 619-285-5040