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General NPI Number Information
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NPI Number | 1184891889
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Entity Type | Organization
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Legal Business Name | KING PROSTHETICS & ORTHOTICS, INC.
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 12849 CHAPMAN AVE
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City | GARDEN GROVE
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State | CA
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Zip | 92840-4100
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Country | US
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Telephone | 714-971-7221
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Fax | 714-971-8784
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Provider Business Mailing Address
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Address Line | 12849 CHAPMAN AVE
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City | GARDEN GROVE
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State | CA
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Zip | 92840-4100
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Country | US
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Telephone | 714-971-7221
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Fax | 714-971-8784
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ALLAN L KING SR.
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Credential | C.P.
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Telephone | 714-971-7221
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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 | SREA24775023
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License Number State | CA
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