NPI 1649290107

San Joaquin Orthotics & Prosthetics

Organisation Prosthetic/Orthotic Supplier Stockton, CA

Practice location

Address: 2211 N California St, Stockton, CA 95204-5503
Phone: (209) 932-0170
Fax: (209) 932-0172

Authorised official

Name: Matthew Shane Evans
Title: Business Owner/Manager
Phone: (209) 932-0170

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X Licence 07-00072230 (CA)

Other Prosthetic/Orthotic Supplier providers in California →

Registry record

NPI: 1649290107
Entity type: Organization
NPI issued: 20 Jul 2006
Record last updated: 15 Sep 2015

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.