Organization
DYNAMICS ORTHOTICS & PROSTHETICS, INC
Active
Parent organization
DYNAMICS ORTHOTICS & PROSTHETICS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DYNAMICS ORTHOTICS & PROSTHETICS, INC
Authorized official
SOPHIA SEAN (DIRECTOR)
(213) 383-9212
Entity
Organization
Contact information
Practice address
2150 N WATERMAN AVE STE 301, SAN BERNARDINO, CA 92404-4811
(909) 881-3612
(909) 881-3613
Mailing address
1830 W OLYMPIC BLVD STE 123, LOS ANGELES, CA 90006-3734
(213) 383-9212
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224900000X
Mastectomy Fitter
—
—
224P00000X
Prosthetist
—
—
225000000X
Orthotic Fitter
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP003476
ABCOP,
CA
05
—
GXC000070
—
CA
Enumeration date
08/04/2020
Last updated
08/04/2020
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