Healthcare Provider Details
I. General information
NPI: 1841479573
Provider Name (Legal Business Name): ADVANCED BIONICS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/30/2007
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
28515 WESTINGHOUSE PL
VALENCIA CA
91355-1398
US
IV. Provider business mailing address
28515 WESTINGHOUSE PL
VALENCIA CA
91355-1398
US
V. Phone/Fax
- Phone: 877-779-0229
- Fax: 877-833-6318
- Phone: 877-779-0229
- Fax: 877-833-6318
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DUC
DIEP
Title or Position: DIRECTOR, REIMBURSEMENT DEPT
Credential:
Phone: 877-829-0026