Provider Demographics
NPI:1588851505
Name:ORTHOPAEDIC SPECIALTIES ASSOCIATES
Entity Type:Organization
Organization Name:ORTHOPAEDIC SPECIALTIES ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCCRACKEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:310-543-2521
Mailing Address - Street 1:4201 TORRANCE BLVD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4504
Mailing Address - Country:US
Mailing Address - Phone:310-543-2521
Mailing Address - Fax:310-543-9352
Practice Address - Street 1:701 E 28TH ST
Practice Address - Street 2:SUITE 117
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2759
Practice Address - Country:US
Practice Address - Phone:310-543-2521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty