ROBERT GARLAND DIRKSEN (NPI# 1558559484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558559484 |
Entity Type | Organization |
Organization Name | ROBERT GARLAND DIRKSEN |
Other Organization Name | CENTRAL ORTHOTIC & PROSTHETIC |
Practice Address |
2039 N Fine Ave Fresno CA 93727-1512 |
Practice Telephone | 5592515557 |
Practice Fax Number | 5592515559 |
Mailing Telephone | 5592515557 |
Mailing Fax Number | 5592515559 |
Enumeration Date | 2007-10-04 |
Last Update Date | 2007-11-19 |
Authorized Official Name | ROBERT GARLAND DIRKSEN (OWNER) |
Authorized Official Telephone | 5592515557 |
Authorized Official Credential | CPO |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | GXC000650 | 05 |
Other Name | Type Code |
---|---|
CENTRAL ORTHOTIC & PROSTHETIC | Doing Business As Name - Organization |
Street Address |
2039 N FINE AVE |
City | FRESNO |
State | CA |
Zip Code | 93727-1512 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699872663 | Robert Garland Dirksen | Orthotist | 2039 N Fine Ave, Fresno, CA 93727-1512 | 2006-09-20 |
1215579230 | Randy S Vallembois | Orthotist | 2039 N Fine Ave, Fresno, CA 93727-1512 | 2019-10-10 |
1366621567 | Tammy Lynn Dirksen | Orthotist | 2039 N Fine Ave, Fresno, CA 93727-1512 | 2007-10-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427524354 | Travis L Minor | Driver | 4573 Kings Canyon Rd, Freso, CA 93727 | 2018-10-18 |
1780178921 | Amanda Hernandez | Behavior Technician | 6358 E Mono St, Fresno, CA 93727 | 2018-06-20 |
1225533169 | Lindsay Fisher | Marriage & Family Therapist | 4928 E Clinton Way Ste 108, Fresno, CA 93727 | 2018-03-23 |
1811351992 | Paulinder Ranu | Pediatrics | 5557 E King Cyn Rd, Fresno, CA 93727 | 2016-04-05 |
1851781371 | Sheri Taylor | Social Worker | 2010 N Fine Ave # 105, Fresno, CA 93727 | 2015-02-04 |
1770917486 | Elouise Jones-green | Counselor | 4491 E. Mckinley Ave #112, Fresno, CA 93727 | 2013-08-29 |
1700227022 | Chee Vang | Counselor | 4855 E Kings Canyon Rd Ste 105, Fresno, CA 93727 | 2013-07-15 |
1578839791 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 5995 E Kings Canyon Rd, Fresno, CA 93727 | 2012-04-02 |
1932411378 | Leticia Ball | Marriage & Family Therapist | 4944 E. Clinton Way, Fresno, CA 93727 | 2010-07-13 |
1639308158 | Juanita Sermeno | Counselor | 4944 E. Clinton, Suite 101, Fresno, CA 93727 | 2009-07-06 |
Find all providers in zip 93727 |
Taxonomy Code | 335E00000X |
Grouping | Suppliers |
Classification | Prosthetic/Orthotic Supplier |
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. |
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871191742 | Alcam Medical Inc. | Prosthetic/Orthotic Supplier | 1244 N Mariposa St Ste 10, Fresno, CA 93703-3929 | 2020-10-13 |
1255938452 | Sheek Hair Boutique | Prosthetic/Orthotic Supplier | 1432 N Cedar Ave Apt 107, Fresno, CA 93703-5303 | 2020-10-01 |
1376183848 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 30 E River Park Pl W Ste 280, Fresno, CA 93720-1547 | 2020-01-13 |
1558560839 | Donna Dye | Prosthetic/Orthotic Supplier | 1145 E Champlain Dr, Fresno, CA 93720-5010 | 2007-07-16 |
1356451462 | Meacham Ent Inc | Prosthetic/Orthotic Supplier | 323 W Cromwell, Ste 118, Fresno, CA 93711-5844 | 2006-08-30 |
1457366874 | Mckinlay Enterprises Inc | Prosthetic/Orthotic Supplier | 343 E Shaw Ave, Fresno, CA 93710-7609 | 2006-07-31 |
1487687083 | Helena Gibson | Prosthetic/Orthotic Supplier | 379 W Shaw Ave, Fresno, CA 93704-2647 | 2006-07-08 |
1164996658 | Restore Medical Inc | Prosthetic/Orthotic Supplier | 7335 N 1st St Ste 109, Fresno, CA 93720-2968 | 2019-01-17 |
1033689831 | Capstone Orthopedic, Inc. | Prosthetic/Orthotic Supplier | 1247 E Alluvial Ave Ste 103, Fresno, CA 93720-2686 | 2018-12-05 |
1942697875 | Active 1 Prosthetics and Orthotics | Prosthetic/Orthotic Supplier | 295 W Cromwell Ave, Suite 102, Fresno, CA 93711-6167 | 2015-04-17 |
Find all providers in FRESNO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.