Provider Demographics
NPI:1972734267
Name:INLAND ARTIFICIAL LIMB & BRACE
Entity type:Organization
Organization Name:INLAND ARTIFICIAL LIMB & BRACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVIDAN
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:951-734-1835
Mailing Address - Street 1:680 PARKRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3124
Mailing Address - Country:US
Mailing Address - Phone:951-734-1835
Mailing Address - Fax:951-734-1538
Practice Address - Street 1:6840 INDIANA AVENUE
Practice Address - Street 2:SUITE 120
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4259
Practice Address - Country:US
Practice Address - Phone:951-781-3011
Practice Address - Fax:951-781-4751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5554470005Medicare NSC