Organization
AMERICAN ORTHOTICS & PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID STEVEN SULIS CPO (CPO, OWNER)
(951) 367-6702
Entity
Organization
Contact information
Practice address
1800 WESTERN AVE STE 205, SAN BERNARDINO, CA 92411-1356
(909) 473-9308
(951) 367-7789
Mailing address
PO BOX 2786, RIVERSIDE, CA 92516-2786
(909) 473-9308
(951) 367-6702
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
CPO02649
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CMS168487
CALIFORNIA CHILDRENS SERVICES
CA
05
—
XA0029550
—
CA
Enumeration date
01/29/2010
Last updated
07/18/2019
Update your record
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