Provider Demographics
NPI:1811991169
Name:ROJEK, LOREN (PRESIDENT AND CPO)
Entity type:Individual
Prefix:MR
First Name:LOREN
Middle Name:
Last Name:ROJEK
Suffix:
Gender:M
Credentials:PRESIDENT AND CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16520 HARBOR BLVD
Mailing Address - Street 2:STE G
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1360
Mailing Address - Country:US
Mailing Address - Phone:714-210-1298
Mailing Address - Fax:714-210-1336
Practice Address - Street 1:16520 HARBOR BLVD
Practice Address - Street 2:STE G
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-1360
Practice Address - Country:US
Practice Address - Phone:714-210-1298
Practice Address - Fax:714-210-1336
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPO01752224P00000X, 222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ07102ZOtherBLUE SHIELD PROVIDER #
CA125510801OtherDEPT OF LABOR PROV. #
CA125518000OtherDEPT. OF LABOR PROV. #
CA006869-0001OtherPACIFICARE PROVIDER #
CA125510802OtherDEPT OF LABOR PROV. #
CA163276OtherCMS#
CAXC0017520OtherMEDI-CAL PROVIDER#
CAZZZ08249ZOtherBLUE SHIELD PROVIDER #
CAZZZ17352ZOtherBLUE SHIELD PROVIDER #
CAGXC000290OtherMEDICAL PROVIDER #
CA0215240003Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
CA0215240001Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
CA125518000OtherDEPT. OF LABOR PROV. #