Organization
VALLEY ORTHOPEDIC TECHNOLOGY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD BOWMAN CO, BOCPO (PRESIDENT)
(818) 600-2560
Entity
Organization
Contact information
Practice address
15243 VANOWEN STREET #208, SUITE 208, VAN NUYS, CA 91405
(818) 600-2560
(818) 600-2561
Mailing address
15243 VANOWEN STREET #208, SUITE 208, VAN NUYS, CA 91405
(818) 600-2560
(818) 600-2561
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255863726
—
CA
Enumeration date
04/03/2017
Last updated
03/31/2020
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