Healthcare Provider Details

I. General information

NPI: 1730180266
Provider Name (Legal Business Name): CAMBRIDGE FOOT AND ANKLE ASSOCIATES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 01/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1038 E CHAPMAN AVENUE
ORANGE CA
92866
US

IV. Provider business mailing address

1038 E CHAPMAN AVENUE
ORANGE CA
92866
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-4191
  • Fax: 714-771-2731
Mailing address:
  • Phone: 714-771-4191
  • Fax: 714-771-2731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY R DESANTIS
Title or Position: OWNER
Credential: DPM
Phone: 714-771-4191