Alpha Iscandari Sanusi, BOCPO

Primary specialty

ProsthetistTaxonomy code 224P00000X

License

C51502 Issued in CA

Practice address

1760 Chicago Ave Ste L21
Riverside, CA 92507-2326

Phone

(626) 622-3359

NPI assigned

Aug 22, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1710534821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 CHICAGO AVE STE L21",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072326",
            "telephone_number": "626-622-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 CHICAGO AVE STE L21",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072326",
            "telephone_number": "626-622-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANUSI",
        "first_name": "ALPHA",
        "middle_name": "ISCANDARI",
        "credential": "BOCPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "CA",
            "license": "C51502",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "CA",
            "license": "C51502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHOTIST/PROSTHETIST CREDENTIAL",
            "identifier": "C51502",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.alcammedical.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "information",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "1760 Chicago Ave Ste L21",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925072326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren-Marife Santos
• Mia Juliana Santos
• Wendy Y Santos
• Paulus L. Santoso, M.D.
• Geovanni Santoyo
• Sayra Sapien
• Yasmin Saqqa
• Cindy Ivette Sarabia
• Michael Amazon Sardar, RN
• Lauren Sardia

• Prosthetist in Riverside, CA
• Providers in Riverside, CA by specialty
• Prosthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.