Provider Demographics
NPI:1417571787
Name:FRISANCHO MEHTA
Entity Type:Organization
Organization Name:FRISANCHO MEHTA
Other - Org Name:ORTHOPAEDIC SURGICAL SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:FRISANCHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-257-1500
Mailing Address - Street 1:23600 TELO AVE STE 180
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4039
Mailing Address - Country:US
Mailing Address - Phone:310-257-1500
Mailing Address - Fax:310-257-1508
Practice Address - Street 1:23600 TELO AVE STE 180
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4039
Practice Address - Country:US
Practice Address - Phone:310-257-1500
Practice Address - Fax:310-257-1508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty