Provider Demographics
NPI:1780728550
Name:O & P IN MOTION, INC.
Entity type:Organization
Organization Name:O & P IN MOTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROSTHETIST ORTHOTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:P
Authorized Official - Last Name:AMBROSET
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:818-881-1785
Mailing Address - Street 1:18913 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-2604
Mailing Address - Country:US
Mailing Address - Phone:818-881-1785
Mailing Address - Fax:818-881-7854
Practice Address - Street 1:18913 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-2604
Practice Address - Country:US
Practice Address - Phone:818-881-1785
Practice Address - Fax:818-881-7854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1643335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ39566ZOtherPROVIDER NUMBER
CA10866OtherVENDOR NUMBER
CAXC0016430Medicaid
CA0320490001Medicare ID - Type Unspecified