Healthcare Provider Details
I. General information
NPI: 1548468614
Provider Name (Legal Business Name): DIMENSION PROSTHETICS & ORTHOTICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2007
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
33374 DOWE AVE
UNION CITY CA
94587-2034
US
IV. Provider business mailing address
33374 DOWE AVE
UNION CITY CA
94587-2034
US
V. Phone/Fax
- Phone: 510-324-3400
- Fax: 510-324-3401
- Phone: 510-324-3400
- Fax: 510-324-3401
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HUONG
THANH
LUU
Title or Position: OWNER
Credential:
Phone: 510-324-3400