Provider Demographics
NPI:1609616481
Name:HOPE ARTIFICIAL LIMB & BRACE,LLC
Entity type:Organization
Organization Name:HOPE ARTIFICIAL LIMB & BRACE,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MINERVA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-246-4645
Mailing Address - Street 1:2607 W BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-2309
Mailing Address - Country:US
Mailing Address - Phone:323-246-4645
Mailing Address - Fax:323-784-2795
Practice Address - Street 1:2244 FARADAY AVE # 105
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7208
Practice Address - Country:US
Practice Address - Phone:323-246-4645
Practice Address - Fax:323-784-2795
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPE ARTIFICIAL LIMB & BRACE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies