DREW HITTENBERGER C.P.BOCO NPI 1952467557

NPI Information

NPI: 1952467557
Provider Name: DREW HITTENBERGER, C.P.,BOCO
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Individual
Address:
181 LYNCH CREEK WAY STE 101
PETALUMA, CA
ZIP 94954
Phone: (707) 765-1122
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Drew Hittenberger, C.P.,BOCO is a prosthetic orthotic supplier in Petaluma, CA. The provider is 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. Drew Hittenberger, C.P.,BOCO NPI is 1952467557. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

181 LYNCH CREEK WAY STE 101
PETALUMA, CA
ZIP 94954-380
Phone: (707) 765-1122
Fax: (707) 765-4571

The enumeration date for this NPI number is 12/28/2006 and was last updated on 11/4/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment			No
2	335E00000X	Prosthetic/Orthotic Supplier		CP 1093	DELAWARE	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4129830001	MEDICARE NSC	CALIFORNIA
2	GXC000120	MEDICAID	CALIFORNIA

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: 5/5/2024

NPI Synchronization or Removal

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