Organization
KAWEAH ORTHOPEDIC & PROSTHETICS INC,.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBBI MARIE BENCOMO CO (CEO)
(559) 741-1300
Entity
Organization
Contact information
Practice address
2318 W SUNNYSIDE AVE STE 7, VISALIA, CA 93277-7266
(559) 741-1300
(559) 741-1819
Mailing address
PO BOX 390, VISALIA, CA 93279-0390
(559) 741-1300
(559) 741-1819
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
BL011033
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XA0141710
—
CA
Enumeration date
07/23/2006
Last updated
06/16/2009
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