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LYDON'S ORTHOTIC SERVICE NPI 1861405516


NPI Information

NPI: 1861405516
Provider Name: LYDON'S ORTHOTIC SERVICE
Classification: Orthotist - 222Z00000X
Entity Type: Organization
Address:
1200 WESTERN STREET
SUITE B
FAIRFIELD, CA
ZIP 94533
Phone: (707) 428-1705
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LYDON'S ORTHOTIC SERVICE is an orthotist in Fairfield, CA. The provider is a health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. LYDON'S ORTHOTIC SERVICE NPI is 1861405516. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1200 WESTERN STREET
SUITE B
FAIRFIELD, CA
ZIP 94533-474
Phone: (707) 428-1705
Fax: (707) 428-1733

The provider's authorized official is Edward Joseph Lydon .
The authorized official title is Owner and has the following contact phone number (707) 428-1705.

The enumeration date for this NPI number is 8/14/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1222Z00000XOrthotistCO1167Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1ZZZ66766ZOTHERCALIFORNIABLUE SHIELD/BLUE CROSS
2XA0011670MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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