Provider Demographics
NPI:1437511003
Name:HOPE ARTIFICIAL LIMB AND BRACE
Entity Type:Organization
Organization Name:HOPE ARTIFICIAL LIMB AND BRACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHYAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMSHIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-246-4645
Mailing Address - Street 1:2609 W BEVERLY BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-2300
Mailing Address - Country:US
Mailing Address - Phone:323-246-4645
Mailing Address - Fax:323-784-2795
Practice Address - Street 1:2609 W BEVERLY BLVD STE 3
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-2300
Practice Address - Country:US
Practice Address - Phone:323-246-4645
Practice Address - Fax:323-784-2795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAS723157335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier