Left Coast Sports Innovations LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

LEFT COAST SPORTS INNOVATIONS LLC

Practice address

403 E Washington Blvd
Los Angeles, CA 90015-3720

Phone

(855) 396-8800

NPI assigned

Sep 20, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Jack Khorsandi

Title

MBR

Phone

(310) 466-9990

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1508589177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 931748",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900931748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153720",
            "telephone_number": "855-396-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEFT COAST SPORTS INNOVATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "KHORSANDI",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "310-466-9990",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Los Angeles, CA
• Providers in Los Angeles, 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 Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.