Organization
BEVERLY HILLS PROSTHETICS ORTHOTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH E. VINNECOUR C.P.O. (PRESIDENT)
(818) 988-0033
Entity
Organization
Contact information
Practice address
15230 BURBANK BLVD, STE 103, VAN NUYS, CA 91411-3534
(818) 988-0033
(818) 988-7219
Mailing address
15230 BURBANK BLVD, STE 103, SHERMAN OAKS, CA 91411-3534
(818) 988-0033
(818) 988-7219
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GXC000260
—
CA
Enumeration date
06/22/2005
Last updated
08/22/2020
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