Provider Demographics
NPI:1275939118
Name:ATLAS ORTHO AND SPINE MEDICAL GROUP
Entity Type:Organization
Organization Name:ATLAS ORTHO AND SPINE MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CATALINO
Authorized Official - Middle Name:D
Authorized Official - Last Name:DUREZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-375-5505
Mailing Address - Street 1:7012 RESEDA BLVD
Mailing Address - Street 2:STE. F
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4219
Mailing Address - Country:US
Mailing Address - Phone:818-776-1171
Mailing Address - Fax:818-776-7425
Practice Address - Street 1:5339 N FRESNO ST
Practice Address - Street 2:STE. 105-E
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6851
Practice Address - Country:US
Practice Address - Phone:559-222-9400
Practice Address - Fax:559-222-9404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty