Individual
MR. FREDERICK FARROKH RANDJBAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BOCPO
Contact information
Practice address
321 E CENTER ST, ANAHEIM, CA 92805-3263
(714) 563-0056
Mailing address
321 E CENTER ST, ANAHEIM, CA 92805-3263
(714) 563-0056
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
C21643
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922099159
TYPE 2 NPI #
—
05
—
XC0216430
—
CA
Enumeration date
02/12/2008
Last updated
02/12/2008
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