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General NPI Number Information
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NPI Number | 1144368390
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Entity Type | Organization
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Legal Business Name | PROSTHETIC & ORTHOTIC GROUP OF VENTURA COUNTY , LLC
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 05/15/2009
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Provider Practice Location Address
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Address Line | 601 E DAILY DR SUITE 122
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City | CAMARILLO
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State | CA
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Zip | 93010-5806
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Country | US
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Telephone | 805-389-0272
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Fax | 805-389-0259
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Provider Business Mailing Address
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Address Line | 601 E. DAILY DR SUITE 122
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City | CAMARILLO
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State | CA
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Zip | 93010-5806
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Country | US
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Telephone | 805-389-0272
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Fax | 805-389-0259
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Authorized Official
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Title or Position | PRESIDENT
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Name | VINCENT GEST
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Credential | CP, BOCO
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Telephone | 805-389-0272
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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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