L.I.C Prosthetics and Orthotics

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

C21643 Issued in MD

Legal business name

L.I.C PROSTHETICS AND ORTHOTICS

Practice address

321 E Center St
Anaheim, CA 92805-3263

Phone

(714) 563-0056

NPI assigned

Nov 4, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Frederick Farrokh Randjbar, BOCPONPI 1932377033

Title

Owner/Director

Phone

(714) 563-0056

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Frederick Farrokh Randjbar, BOCPO

  • Orthotic Fitter
  • Anaheim, CA
  • NPI 1932377033
  NPD Authorized official

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1922099159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 E CENTER ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053263",
            "telephone_number": "714-563-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E CENTER ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053263",
            "telephone_number": "714-563-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L.I.C PROSTHETICS AND ORTHOTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-04",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "RANDJBAR",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "FARROKH",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "714-563-0056",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BOCPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MD",
            "license": "C21643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Anaheim, CA
• Providers in Anaheim, 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 Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.