Provider Demographics
NPI:1407413008
Name:OC FOOT AND ANKLE ASSOCIATES, INC
Entity Type:Organization
Organization Name:OC FOOT AND ANKLE ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANJALA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANDA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:714-669-4422
Mailing Address - Street 1:14642 NEWPORT AVE STE 450
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6092
Mailing Address - Country:US
Mailing Address - Phone:714-669-4422
Mailing Address - Fax:714-669-4444
Practice Address - Street 1:14642 NEWPORT AVE STE 450
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6092
Practice Address - Country:US
Practice Address - Phone:714-669-4422
Practice Address - Fax:714-669-4444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty