MEDICARE: PAULS ORTHOPEDIC APPLIANCES

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		CA

General Provider Information

NPI Number	:	1528069341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAULS ORTHOPEDIC APPLIANCES

Provider Business Mailing Address
First Line	:	2407 OCEAN AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94127-2606
Country	:	US
Telephone Number	:	415-584-4040
Fax Number	:	650-878-5998

Provider Business Practice Location Address
First Line	:	2407 OCEAN AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94127-2606
Country	:	US
Telephone Number	:	415-584-4040
Fax Number	:	650-878-5998

Authorized Official
Title or Position	:	CERTIFIED ORTHOTIST
Name	:	PAUL D CHAVEZ
Credential	:	CO
Telephone Number	:	415-584-4040

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/21/2022

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