Provider Demographics
NPI:1245228428
Name:JANOWITZ, TOBY D (CPO)
Entity type:Individual
Prefix:
First Name:TOBY
Middle Name:D
Last Name:JANOWITZ
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 COMMERCE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-4487
Mailing Address - Country:US
Mailing Address - Phone:661-267-0772
Mailing Address - Fax:661-267-6094
Practice Address - Street 1:525 COMMERCE AVE STE B
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4487
Practice Address - Country:US
Practice Address - Phone:661-267-0772
Practice Address - Fax:661-267-6094
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAXC0153290Medicaid
CAZZZ39886ZOtherBLUE SHIELD
CA0450570001Medicare ID - Type Unspecified