Provider Demographics
NPI:1689196099
Name:ACHILLES PROSTHETICS AND ORTHOTICS, INC
Entity Type:Organization
Organization Name:ACHILLES PROSTHETICS AND ORTHOTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:BS, FAC, CP
Authorized Official - Phone:661-323-5944
Mailing Address - Street 1:2624 F ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1816
Mailing Address - Country:US
Mailing Address - Phone:661-323-5944
Mailing Address - Fax:661-323-2820
Practice Address - Street 1:1435 STATE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2511
Practice Address - Country:US
Practice Address - Phone:805-869-1200
Practice Address - Fax:805-869-1201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-07
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier