Organization
PRIME ORTHOTICS & PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH C PARK BOCP, COA (OWNER)
(213) 817-0134
Entity
Organization
Contact information
Practice address
2727 W OLYMPIC BLVD STE 113, LOS ANGELES, CA 90006-2641
(213) 817-0134
Mailing address
2727 W OLYMPIC BLVD STE 113, LOS ANGELES, CA 90006-2641
(213) 817-0134
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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