MEDICARE: ORTHOPROS 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	:	1538163878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOPROS INC

Provider Business Mailing Address
First Line	:	2021 SANTA MONICA BLVD
Second Line	:	STE 104E
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-2208
Country	:	US
Telephone Number	:	310-828-7485
Fax Number	:	310-828-7067

Provider Business Practice Location Address
First Line	:	2021 SANTA MONICA BLVD
Second Line	:	STE 104E
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-2208
Country	:	US
Telephone Number	:	310-828-7485
Fax Number	:	310-828-7067

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. JOEL L BERNKNOPF
Credential	:	C.O.
Telephone Number	:	310-828-7485

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/06/2011

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Directions to “ORTHOPROS INC ” Practice Location

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