FOUNTAIN VALLEY ORTHOTICS AND PROSTHETICS, INC. (NPI# 1528060662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528060662 |
| Entity Type | Organization |
| Organization Name | FOUNTAIN VALLEY ORTHOTICS AND PROSTHETICS, INC. |
| Other Organization Name | FOUNTAIN ORTHOTICS & PROSTHETICS |
| Practice Address |
16520 Harbor Blvd Suite G Fountain Valley CA 92708-1360 |
| Practice Telephone | 7142101298 |
| Practice Fax Number | 7142101333 |
| Mailing Telephone | 7142101298 |
| Mailing Fax Number | 7142101333 |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2014-03-03 |
| Authorized Official Name | MR. LOREN ROJEK (PRESIDENT) |
| Authorized Official Telephone | 7142101298 |
| Authorized Official Credential | CPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | ========= | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DEPT OF LABOR PROV. # | 125518000 | 01 |
| CA | MEDICAL PROVIDER # | GXC000290 | 01 |
| CA | PACIFICARE PROVIDER # | 006869-0001 | 01 |
| CA | NSC | D08605911 | 01 |
| CA | BLUE SHIELD PROVIDER # | ZZZ17352Z | 01 |
| Other Name | Type Code |
|---|---|
| Fountain Orthotics & Prosthetics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760968796 | Fountain Valley Orthotics and Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 3650 South St Ste 110b, Lakewood, CA 90712-1502 | 2018-07-12 |
| 1720573496 | Fountain Valley Orthotics and Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 500 E Willow St, Long Beach, CA 90806-3115 | 2018-06-26 |
| 1750707055 | Fountain Valley Orthotics and Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 2151 N. Harbor Blvd., Suite 1200, Fullerton, CA 92835-3821 | 2014-03-11 |
| 1225032576 | Fountain Valley Orthotics and Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 351 Hospital Rd, Suite 106, Newport Beach, CA 92663-3503 | 2005-06-01 |
| 1790092237 | Fountain Valley Orthotics and Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 25982 Pala, Suite 100, Mission Viejo, CA 92691-6719 | 2010-09-03 |
| Street Address |
16520 HARBOR BLVD SUITE G |
| City | FOUNTAIN VALLEY |
| State | CA |
| Zip Code | 92708-1360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437697521 | Mark Andrew Cromer | Orthotist | 16520 Harbor Blvd, Suite G, Fountain Valley, CA 92708-1360 | 2017-02-08 |
| 1073744504 | Lisa Gabriela Luna | Orthotist | 16520 Harbor Blvd, Suite G, Fountain Valley, CA 92708-1360 | 2009-07-31 |
| 1811991169 | Loren Rojek | Orthotist | 16520 Harbor Blvd, Ste G, Fountain Valley, CA 92708-1360 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932716222 | Changing Directions Psychological Corporation | Psychologist | 17280 Newhope Street, Suite 4, Fountain Valley, CA 92708 | 2020-09-30 |
| 1124632757 | Neck & Back Pain Specialists, A Balta Chiropractic Corporation | Chiropractor | 10231 Slater Ave. #113, Fountain Valley, CA 92708 | 2020-09-01 |
| 1295205425 | Alexander Nee Dds Inc | Dentist | 337 S Rancho Santa Fe Rd, San Marcos, CA 92708 | 2018-11-30 |
| 1093293052 | Claudia Raquel Santos | Physical Therapist | 18384 Brookhurst Street, Fountain Valley, CA 92708 | 2018-08-01 |
| 1659864338 | Orange County Respiratory Physicians Corp | Internal Medicine | 18111 Brookhurst St Ste 4600, Fountain Valley, CA 92708 | 2018-06-07 |
| 1992297881 | Ereny Abdelmalak Metry | Pharmacist | 9064 Daffodil Ave, Fountain Valley, CA 92708 | 2018-06-06 |
| 1144746348 | Goose Pharma, LLC | Pharmacy | 18049 Magnolia Street, Fountain Valley, CA 92708 | 2017-08-18 |
| 1932622347 | Mayra Alejandra Guerra | Social Worker | 18350 Mt Langley St, Suite 200, Fountain Valley, CA 92708 | 2017-07-18 |
| 1942722129 | Graph Surgery Inc | Plastic Surgery | 10760 Warner Ave, Ste 201, Fountain Valley, CA 92708 | 2017-07-10 |
| 1871022277 | Cathy A Castagna-petersen | Counselor | 10529 Slater Avenue, Fountain Valley, CA 92708 | 2017-06-08 |
| Find all providers in zip 92708 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164443099 | Ultima Resources Inc | Prosthetic/Orthotic Supplier | 18675 Brookhurst St, Fountain Valley, CA 92708-6749 | 2006-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696592 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 3031 W March Ln Ste 216w, Stockton, CA 95219-6500 | 2020-10-14 |
| 1871191742 | Alcam Medical Inc. | Prosthetic/Orthotic Supplier | 1244 N Mariposa St Ste 10, Fresno, CA 93703-3929 | 2020-10-13 |
| 1740887462 | A-z Consulting O & P Services | Prosthetic/Orthotic Supplier | 1133 Smith Ln Ste 5, Roseville, CA 95661-4131 | 2020-10-06 |
| 1255938452 | Sheek Hair Boutique | Prosthetic/Orthotic Supplier | 1432 N Cedar Ave Apt 107, Fresno, CA 93703-5303 | 2020-10-01 |
| 1922615368 | Inland Artificial Limb & Brace | Prosthetic/Orthotic Supplier | 1101 Bryan Ave Ste C, Tustin, CA 92780-4401 | 2020-09-29 |
| 1043823461 | Crystal Johnson | Prosthetic/Orthotic Supplier | 812 S Flower St Apt 4, Inglewood, CA 90301-7913 | 2020-08-25 |
| 1225640220 | Christopher Holloway | Prosthetic/Orthotic Supplier | 4517 Market St Ste 4, Ventura, CA 93003-7841 | 2020-08-20 |
| 1407468416 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 488 E Valley Pkwy Ste 207, Escondido, CA 92025-3368 | 2020-08-20 |
| 1801406269 | Restore Medical Inc | Prosthetic/Orthotic Supplier | 1505 Soquel Dr Ste 4, Santa Cruz, CA 95065-1716 | 2020-07-31 |
| 1801404199 | Covering With Care | Prosthetic/Orthotic Supplier | 21350 Avalon Blvd Unit 5039, Carson, CA 90749-7032 | 2020-07-22 |
| Find all providers with the same taxonomy | ||||
| City | FOUNTAIN VALLEY |
| Zip Code | 92708 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.