=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629959978
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AIMEI DENG CPED/ORTHOTIC FITTER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2025
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1530 S SINCLAIR ST
-----------------------------------------------------
City | ANAHEIM
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92806-5933
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-443-0709
-----------------------------------------------------
Fax | 949-474-4460
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3361 RUTH ELAINE DR
-----------------------------------------------------
City | LOS ALAMITOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90720-3038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-400-7169
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225000000X
-----------------------------------------------------
Taxonomy Name | Orthotic Fitter
-----------------------------------------------------
License Number | CFO05699
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 224L00000X
-----------------------------------------------------
Taxonomy Name | Pedorthist
-----------------------------------------------------
License Number | CPED3872
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------