Organization
PRECISION ORTHOTICS & PROSTHETICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KWON CHAE YI CERTIFIED PROSTHETIS (CHIEF EXECUTIVE OFFICER)
(213) 388-5847
Entity
Organization
Contact information
Practice address
7143 SEVILLE AVE, HUNTINGTON PARK, CA 90255-4905
(213) 388-5847
(213) 388-5848
Mailing address
7143 SEVILLE AVE, HUNTINGTON PARK, CA 90255-4905
(213) 388-5847
(213) 388-5848
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XB0023570
—
CA
01
—
ZZZ655562
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
08/01/2006
Last updated
10/19/2020
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