Organization
WEST COAST ORTHOTIC & PROSTHETIC SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID R VERA SR. CO (PRES)
(209) 550-0100
Entity
Organization
Contact information
Practice address
1705 COFFEE RD, STE 3, MODESTO, CA 95355
(209) 550-0100
(209) 550-0117
Mailing address
1705 COFFEE RD, STE 3, MODESTO, CA 95355
(209) 550-0100
(209) 550-0117
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GXC000700
—
CA
Enumeration date
07/22/2006
Last updated
08/22/2020
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