Healthcare Provider Details

I. General information

NPI: 1922019769
Provider Name (Legal Business Name): HANGER PROSTHETICS & ORTHOTICS WEST, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29645 RANCHO CALIFORNIA RD SUITE 101
TEMECULA CA
92591-6200
US

IV. Provider business mailing address

6377 RIVERSIDE AVE # B SUITE B-100
RIVERSIDE CA
92506-3124
US

V. Phone/Fax

Practice location:
  • Phone: 909-686-5325
  • Fax:
Mailing address:
  • Phone: 909-868-5325
  • 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: SHERYL PRICE
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 503-493-8288