Prosthetic & Orthotic Group San Gabriel Valley, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PROSTHETIC & ORTHOTIC GROUP SAN GABRIEL VALLEY, INC

Practice address

5658 Sepulveda Blvd Ste 206
Van Nuys, CA 91411-2951

Phone

(818) 538-5613

Fax

(626) 256-1405

NPI assigned

Jun 2, 2020

Last updated

Sep 17, 2026By 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

Ivan Sabel

Title

Ceo

Phone

(562) 595-6445

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Prosthetic & Orthotic Group Van Nuys, Inc Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Prosthetic & Orthotic Group San Gabriel Valley, Inc

  • Prosthetic/Orthotic Supplier
  • Duarte, CA
  • NPI 1548718612

  6204191224

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Prosthetic Orthotic Group San Gabriel Valley Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Prosthetic & Orthotic Group San Gabriel Valley, Inc

  • Prosthetic/Orthotic Supplier
  • Duarte, CA
  • NPI 1548718612
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark A. Rodriguez, CPO

  • Orthotist
  • Duarte, CA
  • NPI 1407223365
  NPD
• Jack E. Soulis, CPO

  • Orthotist
  • Duarte, CA
  • NPI 1174025068
  NPD (past)

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1831713189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5658 SEPULVEDA BLVD STE 206",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112951",
            "telephone_number": "818-538-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5658 SEPULVEDA BLVD STE 206",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112951",
            "telephone_number": "818-538-5613",
            "fax_number": "626-256-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC & ORTHOTIC GROUP SAN GABRIEL VALLEY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-02",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "SABEL",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-595-6445"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548718612",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lindamatlock@p-o-group.com",
            "affiliation": "N",
            "address_1": "5658 Sepulveda Blvd Ste 206",
            "city": "Van Nuys",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914112951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Prosthetic & Orthotic Group Van Nuys, Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Van Nuys, CA
• Providers in Van Nuys, 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 Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.