Provider Demographics
NPI:1295077865
Name:STREAMLINE ORTHOPEDIC, INC.
Entity type:Organization
Organization Name:STREAMLINE ORTHOPEDIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:T
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:916-488-1478
Mailing Address - Street 1:125 ASCOT DR STE E
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3408
Mailing Address - Country:US
Mailing Address - Phone:916-488-1478
Mailing Address - Fax:916-488-1807
Practice Address - Street 1:125 ASCOT DR STE E
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3408
Practice Address - Country:US
Practice Address - Phone:916-488-1478
Practice Address - Fax:916-488-1807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-21
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier