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General NPI Number Information
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NPI Number | 1376759506
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Entity Type | Organization
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Legal Business Name | CHANNEL ISLANDS PROSTHETICS-ORTHOTICS
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 02/27/2009
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Provider Practice Location Address
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Address Line | 520 W 5TH ST SUITE A
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City | OXNARD
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State | CA
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Zip | 93030-7025
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Country | US
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Telephone | 805-486-5531
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Fax |
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Provider Business Mailing Address
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Address Line | 4517 MARKET ST SUITE 4
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City | VENTURA
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State | CA
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Zip | 93003-7710
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Country | US
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Telephone | 805-658-1822
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Fax |
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Authorized Official
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Title or Position | PRES.
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Name | JOHN S MCATEE
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Credential | C.P.
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Telephone | 805-658-1822
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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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