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	:	1841398047
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	:	2170 ESPLANADE
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95926-2224
Country	:	US
Telephone Number	:	530-892-1017
Fax Number	:	530-892-1055

Authorized Official
Title or Position	:	CEO
Name	:	IVAN SABEL
Credential	:
Telephone Number	:	541-734-2435

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	05/13/2026

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