Southland Ortho Solutions, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SOUTHLAND ORTHO SOLUTIONS, LLC

Practice address

23362 Peralta Dr Ste 2
Laguna Hills, CA 92653-1711

Phone

(949) 328-9622

NPI assigned

Mar 8, 2021

Last updated

Mar 8, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Fred FortunNPI 1194328187

Title

Principal

Phone

(949) 433-5115

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fred Fortun

  • Durable Medical Equipment & Medical Supplies
  • Laguna Hills, CA
  • NPI 1194328187
  NPD Authorized official

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1669067963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27702 CROWN VALLEY PARKWAY",
            "address_2": "SUITE D-4 #230",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "92694",
            "telephone_number": "949-433-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23362 PERALTA DR STE 2",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531711",
            "telephone_number": "949-328-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND ORTHO SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "FORTUN",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "949-433-5115",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.