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General NPI Number Information
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NPI Number | 1447469143
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Entity Type | Organization
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Legal Business Name | RANCHO BRACING LLC
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 01/07/2011
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Provider Practice Location Address
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Address Line | 26856 ADAMS AVE SUITE 100
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City | MURRIETA
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State | CA
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Zip | 92562-6948
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Country | US
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Telephone | 951-600-7400
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Fax | 951-600-7412
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Provider Business Mailing Address
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Address Line | 26856 ADAMS AVE SUITE 100
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City | MURRIETA
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State | CA
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Zip | 92562-6948
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Country | US
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Telephone | 951-600-7400
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Fax | 951-600-7412
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | PAMELA HEIDE
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Credential |
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Telephone | 951-600-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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