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Mr. Nathan Ryan Lee, CPO
Prosthetic/Orthotic Supplier in Fullerton, California
NPI 1164612131

Nathan Ryan Lee is a Prosthetic/Orthotic Supplier based in Fullerton, CA. Nathan Ryan Lee practices in Fullerton, CA and has the professional credentials of CPO. The NPI Number for Nathan Ryan Lee is 1164612131 and holds a License No. CPO 02709 (California).

The current practice location address for Nathan Ryan Lee is 810 E Chapman Ave, Fullerton, CA and can be reached out via phone at 714-626-0417 and via fax at 714-626-0319.

Location: 810 E Chapman Ave, Fullerton, CA, 92831-3850
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164612131
Provider Name
Nathan Ryan Lee
Credential
CPO
Provider Entity Type
Individual
Gender
Male
Address
810 E Chapman Ave, Fullerton, CA, 92831-3850
Phone Number
714-626-0417
Fax Number
714-626-0319
Provider Enumeration Date
07/26/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
XC0027090 01 CA MEDI-CAL RENDERING
institution
Provider Business Practice Location Address Details
Address
810 E Chapman Ave
City
Fullerton
State
California
Zip
92831-3850
Phone Number
714-626-0417
Fax Number
714-626-0319
person
Provider Business Mailing Address Details
Address
810 E Chapman Ave
City
Fullerton
State
California
Zip
92831-3850
Phone Number
714-626-0417
Fax Number
714-626-0319
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
CPO 02709 ()
Definition
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.
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