Organization
P V O HEALTH CARE
Active
Other names
pomona valley orthopedic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT LEONARD BUSUTTIL BOCPO/CO (OWNER/PRESIDENT)
(909) 629-7615
Entity
Organization
Contact information
Practice address
367 ERVILLA ST, POMONA, CA 91767-3022
(909) 629-7615
(909) 623-7651
Mailing address
367 ERVILLA ST, POMONA, CA 91767-3022
(909) 629-7615
(909) 623-7651
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XC0104380
—
CA
Enumeration date
11/16/2007
Last updated
03/31/2010
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