Central California Leg, Foot, and Ankle Center, Inc.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

CENTRAL CALIFORNIA LEG, FOOT, AND ANKLE CENTER, INC.

Practice address

27462 Portola Pkwy Ste 100
Lake Forest, CA 92610-2838

Phone

(949) 468-2525

NPI assigned

May 15, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Ali Ghorbanifarajzadeh, DPMNPI 1164824249

Title

President

Phone

(305) 310-8155

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Central California Leg, Foot, and Ankle Center, Inc.

  • Foot & Ankle Surgery Podiatrist
  • El Centro, CA
  • NPI 1881281038

  5991119539

  Same PAC ID

Locations

Practitioners 1

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

• Ali Ghorbanifarajzadeh, DPM

  • Primary Podiatric Medicine Podiatrist
  • Bakersfield, CA
  • NPI 1164824249

  Foot & Ankle Surgery

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1417579129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 REGAL",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926203542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27462 PORTOLA PKWY STE 100",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926102838",
            "telephone_number": "949-468-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CALIFORNIA LEG, FOOT, AND ANKLE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-15",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "GHORBANIFARAJZADEH",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-310-8155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.