Organization
ROBERTO D LOPEZ
Active
Other names
Ledus Pedorthic Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERTO DANIEL LOPEZ C. PED., CFO (OWNER)
(760) 352-3336
Entity
Organization
Contact information
Practice address
496 W MAIN ST, EL CENTRO, CA 92243-3019
(760) 352-3336
(760) 352-3271
Mailing address
496 W. MAIN ST, EL CENTRO, CA 92243-3012
(760) 352-3336
(760) 352-3271
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
45656
CA
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417031063
—
CA
Enumeration date
03/25/2008
Last updated
06/21/2017
Update your record
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