Provider Demographics
NPI:1376281287
Name:CENTER FOR ORTHOPEDIC AND SPINE PROCEDURES LLC
Entity Type:Organization
Organization Name:CENTER FOR ORTHOPEDIC AND SPINE PROCEDURES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SERDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-986-0200
Mailing Address - Street 1:16633 VENTURA BLVD STE 802
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1824
Mailing Address - Country:US
Mailing Address - Phone:818-986-0200
Mailing Address - Fax:818-986-4393
Practice Address - Street 1:16633 VENTURA BLVD STE 802
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1824
Practice Address - Country:US
Practice Address - Phone:818-986-0200
Practice Address - Fax:818-986-4393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-22
Last Update Date:2022-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty