Bluebird Orthotics and Prosthetics, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

97948241 Issued in CA

Legal business name

BLUEBIRD ORTHOTICS AND PROSTHETICS, INC.

Practice address

4373 Viewridge Ave
Ste a
San Diego, CA 92123-1619

Phone

(858) 874-6750

Fax

(858) 874-6736

NPI assigned

Jun 12, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Karen Maya

Title

Office Manager

Phone

(858) 874-6750

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258416000000",
    "number": "1700828944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4373 VIEWRIDGE AVE STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92123",
            "telephone_number": "858-874-6750",
            "fax_number": "858-874-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4373 VIEWRIDGE AVE",
            "address_2": "STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231619",
            "telephone_number": "858-874-6750",
            "fax_number": "858-874-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBIRD ORTHOTICS AND PROSTHETICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2009-11-17",
        "status": "A",
        "authorized_official_last_name": "MAYA",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "858-874-6750",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "97948241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GXA000080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in San Diego, CA
• Providers in San Diego, 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 Nov 17, 2009; 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.