Molina Orthopedic Laboratories Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MOLINA ORTHOPEDIC LABORATORIES INC.

Doing business as

Crown City Orthopedic

Practice address

4045 Bonita Rd Ste 208
Bonita, CA 91902-1336

Phone

(619) 489-6120

Fax

(949) 209-4424

NPI assigned

Jun 11, 2006

Reactivated

May 6, 2020

Last updated

Dec 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Temoer Terry

Title

Owner

Phone

(888) 464-9015

Specialties & licenses 1

Addresses

Other names 1

• Crown City Orthopedic Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1588606107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 BONITA RD STE 208",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919021336",
            "telephone_number": "619-489-6120",
            "fax_number": "949-209-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 BONITA RD STE 208",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919021336",
            "telephone_number": "619-489-6120",
            "fax_number": "949-209-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLINA ORTHOPEDIC LABORATORIES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "deactivation_date": "2020-03-30",
        "reactivation_date": "2020-05-06",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "TEMOER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-464-9015"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "natasha@themommycarekit.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4045 Bonita Rd Ste 208",
            "city": "Bonita",
            "state": "CA",
            "country_code": "US",
            "postal_code": "919021336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Crown City Orthopedic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crown City Orthopedic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Bonita, CA
• Providers in Bonita, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; 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.