Legacy Prosthetics & Orthotics

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

LEGACY PROSTHETICS & ORTHOTICS

Doing business as

Coachella Valley Prosthetics and Orthotics

Practice address

75150 Sheryl Ave Ste a
Palm Desert, CA 92211-5118

Phone

(760) 345-4779

Fax

(760) 772-3904

NPI assigned

May 4, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jose R Ledezma, CPOANPI 1467993279

Title

Vicepresident

Phone

(760) 216-3009

Specialties & licenses 1

Addresses

Other names 1

• Coachella Valley Prosthetics and Orthotics Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jose Ramon Ledezma, CPOA CFO

  • Prosthetic/Orthotic Supplier
  • Palm Desert, CA
  • NPI 1467993279
  NPD Authorized official
• Russell Henry Molina

  • Prosthetist
  • Palm Desert, CA
  • NPI 1487341343
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1356030399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75150 SHERYL AVE STE A",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922115118",
            "telephone_number": "760-345-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75150 SHERYL AVE STE A",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922115118",
            "telephone_number": "760-345-4779",
            "fax_number": "760-772-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY PROSTHETICS & ORTHOTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "LEDEZMA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VICEPRESIDENT",
        "authorized_official_telephone_number": "760-216-3009",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPOA"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coachella Valley Prosthetics and Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Lee
• Jason M Lee
• Jonathan Lee
• McKenzie Marie Lee
• Legacy Care Hospice, Inc.
• Legend Gardens, Inc.
• Michael Charles Leitman, PH D PSYCHOLOGY
• Karolina Lemus
• Jonne Arkin Lerner, PH.D
• Robert H Lesnik, M.D.

• Prosthetic/Orthotic Supplier in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.