Provider Demographics
NPI:1386043180
Name:LIND, SOREN
Entity Type:Individual
Prefix:MR
First Name:SOREN
Middle Name:
Last Name:LIND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 BROOKLINE
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1461
Mailing Address - Country:US
Mailing Address - Phone:949-443-4414
Mailing Address - Fax:
Practice Address - Street 1:27 BROOKLINE
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-1461
Practice Address - Country:US
Practice Address - Phone:949-443-4418
Practice Address - Fax:949-487-4768
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter