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General NPI Number Information
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NPI Number | 1255337432
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Entity Type | Organization
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Legal Business Name | BEVERLY HILLS PROSTHETICS ORTHOTICS, INC.
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15230 BURBANK BLVD STE 103
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City | VAN NUYS
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State | CA
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Zip | 91411-3534
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Country | US
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Telephone | 818-988-0033
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Fax | 818-988-7219
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Provider Business Mailing Address
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Address Line | 15230 BURBANK BLVD STE 103
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City | SHERMAN OAKS
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State | CA
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Zip | 91411-3534
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Country | US
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Telephone | 818-988-0033
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Fax | 818-988-7219
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEITH E. VINNECOUR
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Credential | C.P.O.
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Telephone | 818-988-0033
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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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