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General NPI Number Information
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NPI Number | 1578589735
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Entity Type | Organization
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Legal Business Name | LIFE-LIKE PROSTHETICS, LLC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1319 W CARSON ST
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City | TORRANCE
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State | CA
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Zip | 90501-3909
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Country | US
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Telephone | 310-320-5777
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Fax | 310-320-6341
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Provider Business Mailing Address
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Address Line | 1319 W CARSON ST
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City | TORRANCE
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State | CA
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Zip | 90501-3909
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Country | US
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Telephone | 310-320-5777
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Fax | 310-320-6341
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Authorized Official
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Title or Position | OWNER/PROSTHETIC PRACTITIONER
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Name | MR. CARLOS DURAN SAMBRANO
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Credential | CP, BOCP, RPT
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Telephone | 310-320-5777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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