Organization
AMERICAN ORTHOTICS & PROSTHETICS, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID S. SULIS CPO (PROSTHETIST ORTHOTIST (OWNER))
(951) 367-6702
Entity
Organization
Contact information
Practice address
3714 TIBBETTS ST, SUITE 104, RIVERSIDE, CA 92506-2661
(951) 367-6702
(951) 367-7789
Mailing address
PO BOX 2786, RIVERSIDE, CA 92516-2786
(951) 367-6702
(951) 367-7789
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CMS168487
CCS
CA
05
—
XA0029550
—
CA
Enumeration date
07/05/2006
Last updated
11/05/2012
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