Organization
FREMONT ARTIFICIAL LIMB & BRACE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH ALLEN RASMUSSEN CPO (PRESIDENT / CPO)
(510) 792-3475
Entity
Organization
Contact information
Practice address
1999 MOWRY AVE, SUITE J, FREMONT, CA 94538-1723
(510) 792-3475
(510) 792-4864
Mailing address
1999 MOWRY AVE, SUITE J, FREMONT, CA 94538-1723
(510) 792-3475
(510) 792-4864
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
004098
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GXC000530
—
CA
Enumeration date
04/26/2006
Last updated
04/08/2008
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