Active NPI
West Coast Orthotic & Prosthetic Services Inc
- Orthotic Fitter
- Modesto, CA
National Provider Identifier
1215958368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotic Fitter
- Legal business name
- WEST COAST ORTHOTIC & PROSTHETIC SERVICES INC
- Practice address
- 1705 Coffee Rd
Ste 3
Modesto, CA 95355 - Phone
- (209) 550-0100
- Fax
- (209) 550-0117
- NPI assigned
- Jul 22, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. David R Vera Sr., CO
- Title
- Pres
- Phone
- (209) 550-0100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | Primary |
Addresses
Primary practice location
1705 Coffee Rd
Ste 3
Modesto, CA 95355
Mailing address
1705 Coffee Rd
Ste 3
Modesto, CA 95355
Phone (209) 550-0100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GXC000700 | Medicaid | CA |
National Provider Directory
National Provider Directory- Tax ID family
- West Coast Orthotic and Prosthetic
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Prosthetic/Orthotic Supplier
- Lodi, CA
- NPI 1073738563
-
- Prosthetic/Orthotic Supplier
- Stockton, CA
- NPI 1497850630
-
- Prosthetic/Orthotic Supplier
- Oakdale, CA
- NPI 1275758757
Locations
1705 Coffee Rd
Ste 3
Modesto, CA 95355
Phone (209) 550-0100
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthotic Fitter
- Modesto, CA
- NPI 1609011196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1215958368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1705 COFFEE RD",
"address_2": "STE 3",
"city": "MODESTO",
"state": "CA",
"postal_code": "95355",
"telephone_number": "209-550-0100",
"fax_number": "209-550-0117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 COFFEE RD",
"address_2": "STE 3",
"city": "MODESTO",
"state": "CA",
"postal_code": "95355",
"telephone_number": "209-550-0100",
"fax_number": "209-550-0117"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WEST COAST ORTHOTIC & PROSTHETIC SERVICES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-22",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "VERA",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "PRES",
"authorized_official_telephone_number": "209-550-0100",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Sr.",
"authorized_official_credential": "CO"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthotic Fitter",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GXC000700",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.