Temecula Valley Orthoitcs & Prosthetics, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

CPO19140

Legal business name

TEMECULA VALLEY ORTHOITCS & PROSTHETICS, INC.

Practice address

36243 Inland Valley Dr Ste 30
Wildomar, CA 92595-9547

Phone

(951) 696-4447

Fax

(951) 696-4448

NPI assigned

Jul 11, 2006

Organization subpart

No

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

Authorized official

Name

Shawn J Matheny, CO

Title

President

Phone

(951) 696-4447

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Temecula Valley O&P Former legal business name

Locations

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649204801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36243 INLAND VALLEY DR STE 30",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959547",
            "telephone_number": "951-696-4447",
            "fax_number": "951-696-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36243 INLAND VALLEY DR STE 30",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959547",
            "telephone_number": "951-696-4447",
            "fax_number": "951-696-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEMECULA VALLEY ORTHOITCS & PROSTHETICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATHENY",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-696-4447",
        "authorized_official_credential": "CO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": "CPO19140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NUMB",
            "identifier": "ZZZ03626Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "4898339",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET PROVIDER NUMBE",
            "identifier": "5573",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XC0019140",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMS170123",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temecula Valley O&P",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Paul W Taylor, DDS
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• Zoe Tellado
• Temecula Psychiatric Center
• Temecula Valley Radiation Oncology Med Group
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• Nicole Thelwell
• Barbara Ann Thomas, M.P.T.
• Ariella Thomazin

• Prosthetic/Orthotic Supplier in Wildomar, CA
• Providers in Wildomar, 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 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.

Verify at the official NPI Registry.