Fontana Artificial Limb & Brace Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

FONTANA ARTIFICIAL LIMB & BRACE INC.

Practice address

8576 Nuevo Ave
Fontana, CA 92335-3826

Phone

(909) 822-3233

Fax

(909) 822-6480

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey Wayne Wood

Title

President / Certified Prosthetist

Phone

(909) 822-3233

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Avijit Mitra, CPO

  • Prosthetist
  • Hemet, CA
  • NPI 1326236365

  Orthotist

  NPD

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1922104751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8576 NUEVO AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353826",
            "telephone_number": "909-822-3233",
            "fax_number": "909-822-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8576 NUEVO AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353826",
            "telephone_number": "909-822-3233",
            "fax_number": "909-822-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FONTANA ARTIFICIAL LIMB & BRACE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT / CERTIFIED PROSTHETIST",
        "authorized_official_telephone_number": "909-822-3233",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GXC000370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaleesa Follens-Jones-Bush, PT,DPT
• Ashanique Foncham
• Elizabeth E Fong, PHARM D
• Li Ming Fong
• Shirley Fong, MD
• Fontana Chiropractic and Acupuncture
• Fontana Dental Clinic
• Fontana Family Acupuncture Inc.
• Fontana Healthcare, LLC
• Fontana Modern Dentistry, Inc

• Prosthetic/Orthotic Supplier in Fontana, CA
• Providers in Fontana, 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 26, 2008; 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.