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CORDELIA KNOTT WELLNESS FOUNDATION NPI 1932196847


NPI Information

NPI: 1932196847
Provider Name: CORDELIA KNOTT WELLNESS FOUNDATION

Doing Business As: SHOP ON MAIN

Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
230 S MAIN ST
SUITE 100
ORANGE, CA
ZIP 92868
Phone: (714) 541-5563
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CORDELIA KNOTT WELLNESS FOUNDATION is a prosthetic orthotic supplier in Orange, 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. CORDELIA KNOTT WELLNESS FOUNDATION NPI is 1932196847. The provider is registered as an organization entity type.
The provider Is Doing Business As Shop On Main.

The provider's business location address is:

230 S MAIN ST
SUITE 100
ORANGE, CA
ZIP 92868-851
Phone: (714) 541-5563
Fax: (714) 619-3336

The provider's authorized official is Shirley Joyce Moretti .
The authorized official title is President and has the following contact phone number (714) 569-0318.

The enumeration date for this NPI number is 10/5/2005 and was last updated on 8/2/2010.


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
1335E00000XProsthetic/Orthotic SupplierC20007CALIFORNIAYes

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
14589980001MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

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: 11/14/2023

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