Organization
MISSION PROSTHETICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY WANG (MANAGER)
(714) 633-3222
Entity
Organization
Contact information
Practice address
568 N TUSTIN ST, ORANGE, CA 92867
(714) 633-3222
Mailing address
960 N TUSTIN ST # 392, ORANGE, CA 92867-5956
(949) 310-4788
(714) 633-2781
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CGP166024
—
CA
05
—
CMS166024
—
CA
05
—
XB0016630
—
CA
Enumeration date
06/10/2006
Last updated
09/03/2020
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