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General NPI Number Information
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NPI Number | 1245113968
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Entity Type | Organization
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Legal Business Name | PROSTHETICS & ORTHOTICS SPECIALIST LLC
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 2755 BRISTOL ST STE 110
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City | COSTA MESA
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State | CA
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Zip | 92626-5985
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Country | US
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Telephone | 949-455-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 56 SEQUOIA TREE LN
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City | IRVINE
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State | CA
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Zip | 92612-2227
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Country | US
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Telephone | 949-412-2633
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Fax |
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Authorized Official
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Title or Position | OWNER, CEO
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Name | ELHAM SHARIF
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Credential | MSPO, CPO, C.PED
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Telephone | 949-412-2633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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