Organization
PROSTHETICS ETC., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN MICHAEL CAREY CPO, FAAOP (OWNER)
(714) 502-9354
Entity
Organization
Contact information
Practice address
1700 E LINCOLN AVE, 101, ANAHEIM, CA 92805-4323
(714) 502-9354
(714) 502-9455
Mailing address
1700 E LINCOLN AVE, 101, ANAHEIM, CA 92805-4323
(714) 502-9354
(714) 502-9455
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XC0009041
—
CA
Enumeration date
02/02/2007
Last updated
08/05/2011
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