Provider Demographics
NPI:1922615368
Name:INLAND ARTIFICIAL LIMB & BRACE
Entity Type:Organization
Organization Name:INLAND ARTIFICIAL LIMB & BRACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVIDAN
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:951-734-1835
Mailing Address - Street 1:680 PARKRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3124
Mailing Address - Country:US
Mailing Address - Phone:951-734-1835
Mailing Address - Fax:
Practice Address - Street 1:1101 BRYAN AVE STE C
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-4401
Practice Address - Country:US
Practice Address - Phone:714-464-3436
Practice Address - Fax:714-464-4225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier