Vogue Prosthetic Orthotic Center, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

97882728 Issued in CA

Legal business name

VOGUE PROSTHETIC ORTHOTIC CENTER, INC

Practice address

18250 Roscoe Blvd Ste 250
Northridge, CA 91325-4275

Phone

(818) 349-2230

Fax

(818) 349-2267

NPI assigned

Apr 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian M Cronin

Title

Director

Phone

(626) 445-7797

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1023070885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18250 ROSCOE BLVD STE 250",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254275",
            "telephone_number": "818-349-2230",
            "fax_number": "818-349-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18250 ROSCOE BLVD STE 250",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254275",
            "telephone_number": "818-349-2230",
            "fax_number": "818-349-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VOGUE PROSTHETIC ORTHOTIC CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A",
        "authorized_official_last_name": "CRONIN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "626-445-7797"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "97882728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GXC000550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Northridge, CA
• Providers in Northridge, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.