MEDICARE: HANGER PROSTHETICS & ORTHOTICS WEST, 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1487664934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANGER PROSTHETICS & ORTHOTICS WEST, INC.

Provider Business Mailing Address
First Line	:	PO BOX 650846
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0846
Country	:	US
Telephone Number	:	650-559-1711
Fax Number	:	650-559-1893

Provider Business Practice Location Address
First Line	:	298 SAN ANTONIO RD STE 150
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-5306
Country	:	US
Telephone Number	:	650-559-1711
Fax Number	:	650-559-1893

Authorized Official
Title or Position	:	REG COMPLIANCE SPECIALIST III
Name	:	GRACE ANGELINE
Credential	:
Telephone Number	:	714-961-2102

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	10/21/2017

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