NPI 1396506937

Decorated Domes

Organisation Prosthetic/Orthotic Supplier Palmdale, CA

Practice location

Address: 216 Eagle Ln, Palmdale, CA 93551-3613
Phone: (310) 435-0266
Mailing address: PO Box 1393, Mableton, GA 30126-1006

Authorised official

Name: China Upshaw
Title: Owner
Phone: (310) 435-0266

Registered specialties (2)

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

Other Prosthetic/Orthotic Supplier providers in California →

Voluntary or Charitable Agency

Agencies Taxonomy 251V00000X

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Registry record

NPI: 1396506937
Entity type: Organization
NPI issued: 22 Jan 2024
Record last updated: 22 Jan 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.