Healthcare Provider Details

I. General information

NPI: 1528069341
Provider Name (Legal Business Name): PAULS ORTHOPEDIC APPLIANCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2407 OCEAN AVE
SAN FRANCISCO CA
94127-2606
US

IV. Provider business mailing address

2407 OCEAN AVE
SAN FRANCISCO CA
94127-2606
US

V. Phone/Fax

Practice location:
  • Phone: 415-584-4040
  • Fax: 650-878-5998
Mailing address:
  • Phone: 415-584-4040
  • Fax: 650-878-5998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PAUL D CHAVEZ
Title or Position: CERTIFIED ORTHOTIST
Credential: CO
Phone: 415-584-4040