1003804071 NPI number — R AND J PROSTHETIC APPLIANCE CO.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003804071 NPI number — R AND J PROSTHETIC APPLIANCE CO.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
R AND J PROSTHETIC APPLIANCE CO.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003804071
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4517 MARKET ST STE 4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VENTURA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93003-7841
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-643-4063
Provider Business Mailing Address Fax Number:
805-643-5876

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4517 MARKET ST STE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VENTURA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93003-7841
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-643-4063
Provider Business Practice Location Address Fax Number:
805-643-5876
Provider Enumeration Date:
10/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
NEWTON
Authorized Official First Name:
LOGAN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
805-643-4063

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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