Provider Demographics
NPI:1306219845
Name:ORTHOHEALING CENTER ASSOCIATION A CA GENERAL PARTNERSHIP
Entity Type:Organization
Organization Name:ORTHOHEALING CENTER ASSOCIATION A CA GENERAL PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-453-5404
Mailing Address - Street 1:10780 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4749
Mailing Address - Country:US
Mailing Address - Phone:310-453-5404
Mailing Address - Fax:310-453-2535
Practice Address - Street 1:10780 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4749
Practice Address - Country:US
Practice Address - Phone:310-453-5404
Practice Address - Fax:310-453-2535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty