Organization
COASTAL ORTHOTIC AND PROSTHETIC SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED M QUINTANA CPO (PRESIDENT)
(707) 445-3111
Entity
Organization
Contact information
Practice address
2365 HARRISON AVE, EUREKA, CA 95501-3216
(707) 445-3111
(707) 442-8792
Mailing address
2365 HARRISON AVE, EUREKA, CA 95501-3216
(707) 445-3111
(707) 442-8792
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GXC000320
—
CA
Enumeration date
11/30/2007
Last updated
11/30/2007
Update your record
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