Provider Demographics
NPI:1124651971
Name:ACHILLES PROSTHETICS AND ORTHOTICS, INC
Entity type:Organization
Organization Name:ACHILLES PROSTHETICS AND ORTHOTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARBAJAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-323-5944
Mailing Address - Street 1:8800 STOCKDALE HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-1012
Mailing Address - Country:US
Mailing Address - Phone:661-369-8903
Mailing Address - Fax:661-369-8904
Practice Address - Street 1:8800 STOCKDALE HWY STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-1012
Practice Address - Country:US
Practice Address - Phone:661-369-8903
Practice Address - Fax:661-369-8904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier