Provider Demographics
NPI:1639125081
Name:ORTHO ENGINEERING INC.
Entity type:Organization
Organization Name:ORTHO ENGINEERING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:GEVORG
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHKHARIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-559-5996
Mailing Address - Street 1:17037 CHATSWORTH ST STE 207
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5882
Mailing Address - Country:US
Mailing Address - Phone:310-559-5996
Mailing Address - Fax:310-559-5003
Practice Address - Street 1:3680 E IMPERIAL HWY STE 450
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-2659
Practice Address - Country:US
Practice Address - Phone:310-559-5996
Practice Address - Fax:310-559-5003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2022-05-10
Deactivation Date:2021-12-27
Deactivation Code:
Reactivation Date:2022-02-02
Provider Licenses
StateLicense IDTaxonomies
CA97015028335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGXC000510Medicaid
CA0398970001Medicare UPIN