Pro Foot and Ankle Clinic.Inc

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

Legal business name

PRO FOOT AND ANKLE CLINIC.INC

Practice address

9896 Garden Grove Blvd
Garden Grove, CA 92844-1643

Phone

(714) 636-3032

NPI assigned

Jun 21, 2019

Organization subpart

No

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

Authorized official

Name

Luke S Won, DPMNPI 1144625823

Title

DPM/President

Phone

(510) 502-6046

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Luke Won

  • Foot & Ankle Surgery Podiatrist
  • Santa Ana, CA
  • NPI 1144625823
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561075200000",
    "number": "1407417405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9896 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441643",
            "telephone_number": "714-636-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9896 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441643",
            "telephone_number": "714-636-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO FOOT AND ANKLE CLINIC.INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-21",
        "last_updated": "2019-06-21",
        "status": "A",
        "authorized_official_last_name": "WON",
        "authorized_official_first_name": "LUKE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DPM/PRESIDENT",
        "authorized_official_telephone_number": "510-502-6046",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PODIATRY",
            "identifier": "E5409",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sofia Prorok, DPT PT CSCS

• Primary Podiatric Medicine Podiatrist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Primary Podiatric Medicine Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.