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David Steven Sulis, CPO
Prosthetic/Orthotic Supplier in Riverside, California
NPI 1477733962

David Steven Sulis is a Prosthetic/Orthotic Supplier based in Riverside, CA. David Steven Sulis practices in Riverside, CA and has the professional credentials of CPO. The NPI Number for David Steven Sulis is 1477733962 and holds a License No. C22175 (California).

The current practice location address for David Steven Sulis is 3714 Tibbetts St, Riverside, CA and can be reached out via phone at 951-367-6702 and via fax at 951-367-7789.

Location: 3714 Tibbetts St, Riverside, CA, 92506-3020
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477733962
Provider Name
David Steven Sulis
Credential
CPO
Provider Entity Type
Individual
Gender
Male
Address
3714 Tibbetts St, Riverside, CA, 92506-3020
Phone Number
951-367-6702
Fax Number
951-367-7789
Provider Enumeration Date
11/13/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
XA0029550 05 CA
CMS168487 01 CA CCS
institution
Provider Business Practice Location Address Details
Address
3714 Tibbetts St
City
Riverside
State
California
Zip
92506-2661
Phone Number
951-367-6702
Fax Number
951-367-7789
person
Provider Business Mailing Address Details
Address
3714 Tibbetts St
City
Riverside
State
California
Zip
92506-2661
Phone Number
951-367-6702
Fax Number
951-367-7789
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
332BC3200X
License No.
CP002649 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
C22175 (California)
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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