Provider Demographics
NPI:1902948250
Name:VALLEY INSTITUTE OF PROSTHETICS & ORTHOTICS, INC
Entity Type:Organization
Organization Name:VALLEY INSTITUTE OF PROSTHETICS & ORTHOTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:661-322-1005
Mailing Address - Street 1:23033 LYONS AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2777
Mailing Address - Country:US
Mailing Address - Phone:661-253-1191
Mailing Address - Fax:661-253-1343
Practice Address - Street 1:23033 LYONS AVE STE 6
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2777
Practice Address - Country:US
Practice Address - Phone:661-253-1191
Practice Address - Fax:661-253-1343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANOT APPLICABLE335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGXC000271Medicaid
CA0365360001Medicare ID - Type Unspecified