Provider Demographics
NPI:1013206176
Name:TRI STAR ORTHOPAEDICS
Entity Type:Organization
Organization Name:TRI STAR ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:T
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:213-382-2030
Mailing Address - Street 1:440 SHATTO PL
Mailing Address - Street 2:STE 208
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1836
Mailing Address - Country:US
Mailing Address - Phone:213-382-2030
Mailing Address - Fax:866-438-5974
Practice Address - Street 1:440 SHATTO PL
Practice Address - Street 2:STE 208
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1836
Practice Address - Country:US
Practice Address - Phone:213-382-2030
Practice Address - Fax:866-438-5974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22101111N00000X
CAAC13472171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT28321OtherPHYSICAL THERAPY
CAPT19584OtherPHYSICAL THERAPY