Provider Demographics
NPI:1881286763
Name:OC FOOT AND ANKLE ASSOCIATES, INC
Entity type:Organization
Organization Name:OC FOOT AND ANKLE ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANJALA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANDA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:714-669-4422
Mailing Address - Street 1:9901 PARAMOUNT BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3853
Mailing Address - Country:US
Mailing Address - Phone:562-923-0371
Mailing Address - Fax:
Practice Address - Street 1:9901 PARAMOUNT BLVD STE 202
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3853
Practice Address - Country:US
Practice Address - Phone:562-923-0371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OC FOOT AND ANKLE ASSOCIATES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E4633Medicaid