Gary R Bolin, CO
Individual provider Active NPI Orthotist · Foothill Ranch, CA
NPI 1831267400 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1831267400
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthotist 222Z00000X
- License
- CO3161
- Practice address
- 74 Fairfield
Foothill Ranch, CA 92610-1855 - Phone
- (949) 716-9091
- Fax
- (949) 916-9245
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | CO3161 | Yes |
Addresses
Primary practice location
74 Fairfield
Foothill Ranch, CA 92610-1855
Mailing address
74 Fairfield
Foothill Ranch, CA 92610-1855
Phone (949) 716-9091
Other providers in Foothill Ranch, CA
- Ratandeep Kaur Bawa
- Kyleigh Beatty
- Rachel Anne Bee
- Bella Chau, Inc.
- David Charles Blakely
- Bozorgmanesh Corp
- Cherrie Bravo
- Jennifer Marie Brouwers
- Suzanne Marie Buchanan-Perry
- Alison Burney
All providers in Foothill Ranch, CA · Orthotist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.