Healthcare Provider Details

I. General information

NPI: 1952346298
Provider Name (Legal Business Name): TERRAPIN TECHNOLOGIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 CABRILLO AVE SUITE A
TORRANCE CA
90501-2801
US

IV. Provider business mailing address

1508 CABRILLO AVE SUITE A
TORRANCE CA
90501-2801
US

V. Phone/Fax

Practice location:
  • Phone: 310-212-3067
  • Fax: 888-776-9566
Mailing address:
  • Phone: 310-212-3067
  • Fax: 888-776-9566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number100632
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberCP002624
License Number StateVA

VIII. Authorized Official

Name: MRS. DALILA BAINER
Title or Position: CEO
Credential: BOC
Phone: 310-212-3067