Provider Demographics
NPI:1356558233
Name:ADEPT PROSTHETICS
Entity type:Organization
Organization Name:ADEPT PROSTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROSTHETIST
Authorized Official - Prefix:MR
Authorized Official - First Name:J
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:714-547-6106
Mailing Address - Street 1:1106 E 17TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-2603
Mailing Address - Country:US
Mailing Address - Phone:714-547-6106
Mailing Address - Fax:714-550-7443
Practice Address - Street 1:1106 E 17TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-2603
Practice Address - Country:US
Practice Address - Phone:714-547-6106
Practice Address - Fax:714-550-7443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC22302332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1356558233OtherNPI
CA1356558233OtherNPI