MEDICARE: ACHILLES PROSTHETICS AND ORTHOTICS, 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		CA

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
2	ZZZ80407Z	OTHER	CA	BLUE SHIELD
3	1659377836	OTHER	CA	CALIFORNIA CHILDREN SERVICES
4	199156400	OTHER	CA	U.S. DEPARTMENT OF LABOR

General Provider Information

NPI Number	:	1659377836
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACHILLES PROSTHETICS AND ORTHOTICS, INC

Provider Business Mailing Address
First Line	:	2624 F ST
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-1816
Country	:	US
Telephone Number	:	661-323-5944
Fax Number	:	661-323-2820

Provider Business Practice Location Address
First Line	:	2624 F ST
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-1816
Country	:	US
Telephone Number	:	661-323-5944
Fax Number	:	661-323-2820

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANIEL J NEWTON
Credential	:	B.S., F.A.C.,C.P.
Telephone Number	:	661-323-5944

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	09/18/2013

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