Organization
WEST COAST ORTHOTIC & PROSTHETIC SER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID R VERA CO (PRESIDENT)
(209) 333-1148
Entity
Organization
Contact information
Practice address
400 E KETTLEMAN LN, SUITE 1, LODI, CA 95240-5962
(209) 333-1148
(209) 333-0624
Mailing address
400 E KETTLEMAN LN, SUITE 1, LODI, CA 95240-5962
(209) 333-1148
(209) 333-0624
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GXC000100
—
CA
Enumeration date
01/27/2006
Last updated
08/22/2020
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