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NPI Code Detail

MEDICARE: JESSE RASMUSSEN CPO

MEDICARE:   JESSE  RASMUSSEN  CPO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Z00000XOrthotist
2224P00000XProsthetist

General Provider Information

NPI Number : 1366121576
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE RASMUSSEN CPO
Provider Business Mailing Address
First Line : 15602 MOSHER AVE
Second Line :
City : TUSTIN
State : CA
Zip : 92780-6427
Country : US
Telephone Number : 949-474-2050
Fax Number : 949-474-4460
Provider Business Practice Location Address
First Line : 1530 S SINCLAIR ST
Second Line :
City : ANAHEIM
State : CA
Zip : 92806-5933
Country : US
Telephone Number : 949-474-2050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2023
Last Update Date : 07/14/2023

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Directions to “ JESSE RASMUSSEN CPO” Practice Location

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