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General NPI Number Information
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NPI Number | 1073569554
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Entity Type | Organization
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Legal Business Name | PROSTHETIC & ORTHOTIC GROUP, INC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 2669 MYRTLE AVE STE 101
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City | SIGNAL HILL
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State | CA
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Zip | 90755
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Country | US
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Telephone | 562-595-6445
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Fax | 562-424-3122
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Provider Business Mailing Address
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Address Line | 2669 MYRTLE AVE STE 101
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City | SIGNAL HILL
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State | CA
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Zip | 90755-2746
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Country | US
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Telephone | 562-595-6445
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Fax | 562-424-3122
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GLENN MATSUSHIMA
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Credential |
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Telephone | 562-595-6445
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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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