Provider Demographics
NPI:1568617868
Name:ORANGE COAST PROSTHETICS INC.
Entity Type:Organization
Organization Name:ORANGE COAST PROSTHETICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DINO
Authorized Official - Middle Name:LOREN
Authorized Official - Last Name:LACAPRIA
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:714-357-3940
Mailing Address - Street 1:2324 N BATAVIA ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-2019
Mailing Address - Country:US
Mailing Address - Phone:714-637-2788
Mailing Address - Fax:714-637-6941
Practice Address - Street 1:2324 N BATAVIA ST
Practice Address - Street 2:SUITE 104
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-2019
Practice Address - Country:US
Practice Address - Phone:714-637-2788
Practice Address - Fax:714-637-6941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA335E00000X335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
6216880001Medicare NSC