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General NPI Number Information
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NPI Number | 1003150210
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Entity Type | Organization
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Legal Business Name | ELITE BIOMECHANICAL DESIGN
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Dates
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Enumeration Date | 11/12/2012
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Last Update Date | 06/25/2013
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Provider Practice Location Address
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Address Line | 1100 GARDEN HWY SUITE 900
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City | YUBA CITY
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State | CA
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Zip | 95991-7592
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Country | US
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Telephone | 530-673-6913
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Fax | 530-671-6915
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Provider Business Mailing Address
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Address Line | 1100 GARDEN HWY SUITE 900
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City | YUBA CITY
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State | CA
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Zip | 95991-7592
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Country | US
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Telephone | 530-673-6913
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Fax | 530-671-6915
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Authorized Official
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Title or Position | CEO, CFO
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Name | MR. MICHAEL PATRICK CASEY
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Credential | BOCO
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Telephone | 530-894-6913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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