| Doctor Name: | MR. MANUEL BOUFFARD |
| NPI Number: | 1316925282 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OTR CHT |
| License Number: | 00978 |
| Business Practice Address: | 4010 Orange Ave Long Beach, CA - 908072374 |
| Business Phone Number: | 5624283556 |
| Business Fax Number: | 5624283621 |
| Mailing Address: | 4010 Orange Ave, LONG BEACH |
| State: | CA |
| Postal Code: | 908073717 |
| Phone Number: | 5624283556 |
| Fax Number: | 5624283621 |
| NPI Enumeration Date: | 01/02/2006 |
| NPI Last Update Date: | 11/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225000000X |
| License Number: | 00978 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Orthotic Fitter |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the management of fitting prefabricated orthoses. |