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Organization
WEST COAST DME & SUPPLIES LLC
Active
Organization
WEST COAST DME & SUPPLIES LLC
Active
Parent organization
WEST COAST DME & SUPPLIES LLC
Other names
OrthoKinetix
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST COAST DME & SUPPLIES LLC
Authorized official
MR. MICHAEL GREGORY WELLS C.PED (PRESIDENT)
(909) 908-3920
Entity
Organization
Contact information
Practice address
8322 CLAIREMONT MESA BLVD STE 105, SAN DIEGO, CA 92111-1317
(909) 477-3117
(909) 303-9244
Mailing address
1835 CHICAGO AVE STE A, RIVERSIDE, CA 92507-2309
(909) 477-3117
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
NULL
222Z00000X
Orthotist
—
—
224L00000X
Pedorthist
—
NULL
224L00000X
Pedorthist
—
—
224P00000X
Prosthetist
—
NULL
224P00000X
Prosthetist
—
—
225000000X
Orthotic Fitter
—
NULL
225000000X
Orthotic Fitter
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
05/24/2019
Last updated
05/24/2019
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