Provider Demographics
NPI:1912955881
Name:VALLEY INSTITUTE OF PROSTHETICS & ORTHOTICS, INC.
Entity type:Organization
Organization Name:VALLEY INSTITUTE OF PROSTHETICS & ORTHOTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:661-322-1005
Mailing Address - Street 1:1524 21ST ST
Mailing Address - Street 2:STE. B
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-4002
Mailing Address - Country:US
Mailing Address - Phone:661-322-1005
Mailing Address - Fax:661-322-0528
Practice Address - Street 1:1524 21ST ST
Practice Address - Street 2:STE. B
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-4002
Practice Address - Country:US
Practice Address - Phone:661-322-1005
Practice Address - Fax:661-322-0528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANOT APPLICABLE335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACGP143880Medicaid
CAGXC000270Medicaid
CA0365360003Medicare ID - Type Unspecified