Organization
LEFT COAST SPORTS INNOVATIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK KHORSANDI (MBR)
(310) 466-9990
Entity
Organization
Contact information
Practice address
403 E WASHINGTON BLVD, LOS ANGELES, CA 90015-3720
(855) 396-8800
Mailing address
PO BOX 931748, LOS ANGELES, CA 90093-1748
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/20/2022
Last updated
10/03/2022
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