West Coast Orthotic & Prosthetic Ser Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

WEST COAST ORTHOTIC & PROSTHETIC SER INC

Practice address

400 E Kettleman LN
Suite 1
Lodi, CA 95240-5962

Phone

(209) 333-1148

Fax

(209) 333-0624

NPI assigned

Jan 27, 2006

Last updated

Aug 22, 2020By 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

Mr. David R Vera, CO

Title

President

Phone

(209) 333-1148

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841261955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E KETTLEMAN LN",
            "address_2": "SUITE 1",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405962",
            "telephone_number": "209-333-1148",
            "fax_number": "209-333-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E KETTLEMAN LN",
            "address_2": "SUITE 1",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405962",
            "telephone_number": "209-333-1148",
            "fax_number": "209-333-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST ORTHOTIC & PROSTHETIC SER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VERA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-333-1148",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GXC000100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allyssa Katherine Ward
• Ben Gervas Watson, MD
• Kevin S Watt, DC
• Tina S Watt, DC
• Weiping Yao, M.D., a Professional Corporation
• West Coast Orthotic and Prosthetic
• Western Dental Services, Inc.
• Western Health Resources (Adventist Health Home Care Services)
• Lisa Wexler
• David Weymouth, CPO

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