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General NPI Number Information
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NPI Number | 1689856833
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Entity Type | Organization
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Legal Business Name | TIMOTHY D. BULGARELLI
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 01/10/2008
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Provider Practice Location Address
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Address Line | 24811 SAN FERNANDO RD SUITE O
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City | SANTA CLARITA
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State | CA
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Zip | 91321-4133
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Country | US
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Telephone | 661-254-8461
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Fax | 661-254-7887
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Provider Business Mailing Address
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Address Line | 24811 SAN FERNANDO RD SUITE O
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City | SANTA CLARITA
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State | CA
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Zip | 91321-4133
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Country | US
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Telephone | 661-254-8461
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Fax | 661-254-7887
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY BULGARELLI
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Credential | CPO
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Telephone | 626-793-7103
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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 | CPO00731
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License Number State |
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