MEDICARE: SPECTRUM ORTHOTICS AND PROSTHETICS, INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376818070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECTRUM ORTHOTICS AND PROSTHETICS, INC

Provider Business Mailing Address
First Line	:	2170 ESPLANADE
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95926-2224
Country	:	US
Telephone Number	:	530-892-1017
Fax Number	:	530-892-1055

Provider Business Practice Location Address
First Line	:	2275 MYERS ST STE C
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95966-5319
Country	:	US
Telephone Number	:	530-538-9500
Fax Number	:	530-538-9400

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. FOREST R SEXTON
Credential	:
Telephone Number	:	541-734-2435

Provider Enumeration Date	:	03/13/2012
Last Update Date	:	11/14/2022

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Directions to “SPECTRUM ORTHOTICS AND PROSTHETICS, INC ” Practice Location

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