Timothy D. Bulgarelli

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

CPO00731

Legal business name

TIMOTHY D. BULGARELLI

Practice address

24811 San Fernando Rd
Suite O
Santa Clarita, CA 91321-4133

Phone

(661) 254-8461

Fax

(661) 254-7887

NPI assigned

Nov 29, 2007

Organization subpart

No

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

Authorized official

Name

Timothy Bulgarelli, CPO

Title

Owner

Phone

(626) 793-7103

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pacific Prosthetics & Orthotics Doing business as

Locations

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1689856833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24811 SAN FERNANDO RD",
            "address_2": "SUITE O",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913214133",
            "telephone_number": "661-254-8461",
            "fax_number": "661-254-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24811 SAN FERNANDO RD",
            "address_2": "SUITE O",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913214133",
            "telephone_number": "661-254-8461",
            "fax_number": "661-254-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY D. BULGARELLI",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "BULGARELLI",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-793-7103",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": "CPO00731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XC0007310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Santa Clarita, CA
• Providers in Santa Clarita, 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 Jan 10, 2008; 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.