Organization
TIMOTHY D. BULGARELLI
Active
Other names
Pacific Prosthetics & Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
EMMA RICHARDSON (OFFICE MANAGER)
(626) 793-7103
Entity
Organization
Contact information
Practice address
454 N CRAIG AVE, PASADENA, CA 91107-2460
(626) 793-7103
(626) 793-8332
Mailing address
454 N CRAIG AVE, PASADENA, CA 91107-2460
(626) 793-7103
(626) 793-8332
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CPO00731
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ42904Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
10/02/2007
Last updated
10/17/2008
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