# INNOVATIVE FEDERAL OPERATIONS GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** IFOG
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487928123
- **Authorized official:** MR. LARRY L WICK (CEO)
- **Authorized official phone:** (760) 889-9425

## Contact information

- **Practice address:** 640 E VISTA WAY, SUITE B, VISTA, CA 92084-5535
- **Practice address phone:** (760) 536-4144
- **Practice address fax:** (888) 415-8297
- **Mailing address:** 640 E VISTA WAY, SUITE B, VISTA, CA 92084-5535
- **Mailing address phone:** (760) 536-4144
- **Mailing address fax:** (888) 415-8297

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | FHB101207653 | CA | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | B2009034145 | CA | — |

## Other

- **Enumeration date:** 02/27/2012
- **Last updated:** 02/27/2012