Organization
CROWN CITY ORTHOTICS AND PROSTHETICS LLC.
Active
Other names
Molina Orthopedic Laboratories Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN P MOLINA ORTHOTISTS (CEO/PRESIDENT OF COMPANY)
(626) 432-2890
Entity
Organization
Contact information
Practice address
2824 E FOOTHILL BLVD, PASADENA, CA 91107-3400
(626) 431-2890
(626) 431-2892
Mailing address
2824 E FOOTHILL BLVD, PASADENA, CA 91107-3400
(626) 431-2890
(626) 431-2892
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO003823
AMERICAN BOARD ACCREDIDATION (ABC) ORTHOTIST
CA
Enumeration date
03/11/2020
Last updated
12/10/2021
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