Provider Demographics
NPI:1255542668
Name:FURUSHIRO, RANDY FURUSHIRO (CPO)
Entity type:Individual
Prefix:MR
First Name:RANDY
Middle Name:FURUSHIRO
Last Name:FURUSHIRO
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7531 WATERVILLE PL
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-3088
Mailing Address - Country:US
Mailing Address - Phone:408-848-4446
Mailing Address - Fax:408-848-4446
Practice Address - Street 1:535 E ROMIE LN STE 3
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4026
Practice Address - Country:US
Practice Address - Phone:408-848-4446
Practice Address - Fax:408-848-4446
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPO851222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAXC0008510Medicaid