Organization
LIMB CRAFT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN RYAN LEE CPO (PRESIDENT)
(714) 626-0417
Entity
Organization
Contact information
Practice address
810 E CHAPMAN AVE, SUITE C, FULLERTON, CA 92831-3850
(714) 626-0417
(714) 626-0319
Mailing address
810 E CHAPMAN AVE, SUITE C, FULLERTON, CA 92831-3850
(714) 626-0417
(714) 626-0319
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CPO02709
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5140637
MEDI-CAL PIN
CA
01
—
GXC000930
MEDI-CAL GROUP
CA
01
—
ZZZ69704Z
BLUE SHEILD
CA
Enumeration date
11/02/2006
Last updated
08/01/2022
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