Provider Demographics
NPI:1396312062
Name:BIONICS ORTHOTICS AND PROSTHETICS INC.
Entity type:Organization
Organization Name:BIONICS ORTHOTICS AND PROSTHETICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-270-9972
Mailing Address - Street 1:3737 MORAGA AVE STE B107
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-5300
Mailing Address - Country:US
Mailing Address - Phone:858-270-9972
Mailing Address - Fax:
Practice Address - Street 1:1553 GRAND AVE STE B
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2427
Practice Address - Country:US
Practice Address - Phone:858-270-9972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIONICS ORTHOTICS AND PROSTHETICS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier