MEDICARE: NORTH BAY PROSTHETICS AND ORTHOTICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1255866968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH BAY PROSTHETICS AND ORTHOTICS LLC

Provider Business Mailing Address
First Line	:	671 ELMIRA RD
Second Line	:	SUITE 120
City	:	VACAVILLE
State	:	CA
Zip	:	95687-4655
Country	:	US
Telephone Number	:	707-724-8985
Fax Number	:	707-724-8986

Provider Business Practice Location Address
First Line	:	671 ELMIRA RD
Second Line	:	SUITE 120
City	:	VACAVILLE
State	:	CA
Zip	:	95687-4655
Country	:	US
Telephone Number	:	707-724-8985
Fax Number	:	707-724-8986

Authorized Official
Title or Position	:	CEO
Name	:	IVAN SABEL
Credential	:
Telephone Number	:	707-425-5028

Provider Enumeration Date	:	05/01/2017
Last Update Date	:	05/13/2026

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