Provider Demographics
NPI:1568557478
Name:RGP ORTHOPEDIC APPLIANCE CO INC
Entity Type:Organization
Organization Name:RGP ORTHOPEDIC APPLIANCE CO INC
Other - Org Name:RGP PROSTHETIC RESEARCH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTH
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:619-582-3871
Mailing Address - Street 1:6147 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115
Mailing Address - Country:US
Mailing Address - Phone:619-582-3871
Mailing Address - Fax:619-582-3999
Practice Address - Street 1:6147 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115
Practice Address - Country:US
Practice Address - Phone:619-582-3871
Practice Address - Fax:619-582-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGXB000030Medicaid
CAZZZ72596ZOtherBLUE SHIELD
CAZZZ72596ZOtherBLUE SHIELD