Healthcare Provider Details

I. General information

NPI: 1447515531
Provider Name (Legal Business Name): JAMES W DRYDEN, CPO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10711 RIVERSIDE DR
NORTH HOLLYWOOD CA
91602-2312
US

IV. Provider business mailing address

10711 RIVERSIDE DR
NORTH HOLLYWOOD CA
91602-2312
US

V. Phone/Fax

Practice location:
  • Phone: 818-753-1316
  • Fax: 818-509-0451
Mailing address:
  • Phone: 818-753-1316
  • Fax: 818-509-0451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JAMES WILLIAM DRYDEN
Title or Position: OWNER/PRESIDENT
Credential: CPO
Phone: 818-753-1316