Most Relevant Information
Provider Data
| NPI Number: | 1003071184 |
| Provider Name: | FERNANDO MEDINA ORTHOTIST |
| Entity Type: | Individual |
| Taxonomy Code: | 222Z00000X |
| Specialty: | Orthotist |
| License Number: | C36368 |
Most Important Dates
| Enumeration Date: | 07/28/2008 |
| Last Updated: | 07/28/2008 |
Provider Practice Location
13340 FIRESTONE BLVD
UNIT G
SANTA FE SPRINGS
CA
906705558
Practice Location Phone/Fax
| Phone: | 9513510019 |
| Fax: | 9513511279 |
Provider Mailing Location
13340 FIRESTONE BLVD
UNIT G
SANTA FE SPRINGS
CA
906705558
Provider Mailing Phone/Fax
| Phone: | 9513510019 |
| Fax: | 9513511279 |