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General NPI Number Information
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NPI Number | 1891358610
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Entity Type | Organization
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Legal Business Name | AMERICAN MEDICAL O&P CLINIC, INC.
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 4955 VAN NUYS BLVD STE 514
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1831
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Country | US
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Telephone | 818-988-5414
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Fax | 818-988-5415
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Provider Business Mailing Address
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Address Line | 4955 VAN NUYS BLVD STE 514
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1831
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Country | US
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Telephone | 818-988-5414
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Fax | 818-988-5415
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Authorized Official
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Title or Position | OWNER
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Name | MS. KONSTANDIN KUMURYAN
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Credential | CPED
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Telephone | 818-988-5414
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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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