CUSTOM ORTHOPEDIC APPLIANCES, INC. (NPI# 1821175050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821175050 |
| Entity Type | Organization |
| Organization Name | CUSTOM ORTHOPEDIC APPLIANCES, INC. |
| Practice Address |
340 Divisadero St San Francisco CA 94117-2209 |
| Practice Telephone | 4155521330 |
| Practice Fax Number | 4158612955 |
| Mailing Telephone | 4155521330 |
| Mailing Fax Number | 4158612955 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | WALTER KONIUK (OWNER/CERTIFIED ORTHOTIST) |
| Authorized Official Telephone | 4155521330 |
| Authorized Official Credential | CO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GFA000060 | 05 |
| Street Address |
340 DIVISADERO ST |
| City | SAN FRANCISCO |
| State | CA |
| Zip Code | 94117-2209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497231765 | Tsz Ching Isaac Chung | Counselor | 2020 Hayes Street, San Francisco, CA 94117 | 2018-07-19 |
| 1124578901 | Michelle Elizabeth Cohen | Nurse Practitioner | 350 Parnassus Ave Ste 908, San Francisco, CA 94117 | 2016-10-05 |
| 1235686346 | Amy Burtelow | Massage Therapist | 425 Divisadero Street Suite 300, San Francisco, CA 94117 | 2016-09-07 |
| 1851790430 | Elissa Stevens | Counselor | 1757 Waller Street, San Francisco, CA 94117 | 2014-08-19 |
| 1831508043 | Colmed Laboratories & Radiology | Clinical Medical Laboratory | 560 Haight Street #104, San Francisco, CA 94117 | 2014-08-13 |
| 1972917847 | Radha Yerneni | Internal Medicine | 450 Stanyan St Fl 6, San Francisco, CA 94117 | 2014-06-18 |
| 1811333594 | Julia Wong | Counselor | 425 Divisadero Street, Suite 300, San Francisco, CA 94117 | 2013-05-21 |
| 1740623529 | Cody Elizabeth Berry | Social Worker | 425 Divisadero, Suite 300, San Francisco, CA 94117 | 2013-04-11 |
| 1235471848 | Steven Ryan Vidrine | Psychiatry & Neurology | 350 Parnassus Ave Ste 201, San Francisco, CA 94117 | 2013-03-21 |
| 1699043810 | Podiatry Plan Inc | Podiatrist | 1353b Haight Street, San Francisco, CA 94117 | 2011-12-02 |
| Find all providers in zip 94117 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629624127 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 1100 Van Ness Ave Ste 1000, San Francisco, CA 94109-6920 | 2019-08-12 |
| 1780978726 | Enes Inc | Prosthetic/Orthotic Supplier | 1221 Divisadero St, San Francisco, CA 94115-3910 | 2011-06-07 |
| 1306915749 | San Francisco Prosthetic Orthotic Service, Inc. | Prosthetic/Orthotic Supplier | 330 Divisadero St, San Francisco, CA 94117-2209 | 2006-11-08 |
| 1720174741 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 285 Winston Dr, San Francisco, CA 94132-1921 | 2006-10-05 |
| 1003824319 | Davis Foot Comfort Center, Inc. | Prosthetic/Orthotic Supplier | 3921 Judah St, San Francisco, CA 94122-1120 | 2006-08-03 |
| 1992721369 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 865 Market St, San Francisco, CA 94103-1900 | 2006-07-15 |
| 1528069341 | Pauls Orthopedic Appliances | Prosthetic/Orthotic Supplier | 2407 Ocean Ave, San Francisco, CA 94127-2606 | 2005-08-02 |
| 1881050185 | 121 Care LLC | Prosthetic/Orthotic Supplier | 424 9th St, Suite 200, San Francisco, CA 94103-4411 | 2016-01-04 |
| 1780076398 | Global Surgeries, Inc. | Prosthetic/Orthotic Supplier | 1700 California St, Suite #340, San Francisco, CA 94109-4586 | 2015-02-19 |
| 1205192085 | D Danz & Sons Inc | Prosthetic/Orthotic Supplier | 450 Sutter Street, #703, San Francisco, CA 94108-4206 | 2012-04-06 |
| Find all providers in SAN FRANCISCO | ||||
| City | SAN FRANCISCO |
| Zip Code | 94117 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.