Provider Demographics
NPI:1306270798
Name:RABBIT'S FOOT ORTHOTICS AND PROSTHETICS
Entity type:Organization
Organization Name:RABBIT'S FOOT ORTHOTICS AND PROSTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:858-943-1691
Mailing Address - Street 1:12540 OAKS NORTH DR
Mailing Address - Street 2:SUITE B3
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-1608
Mailing Address - Country:US
Mailing Address - Phone:858-943-1691
Mailing Address - Fax:858-451-3097
Practice Address - Street 1:12540 OAKS NORTH DR
Practice Address - Street 2:SUITE B3
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-1608
Practice Address - Country:US
Practice Address - Phone:858-943-1691
Practice Address - Fax:858-451-3097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier