Provider Demographics
NPI:1609911460
Name:SOUTH COUNTY ORTHOPEDICS
Entity Type:Organization
Organization Name:SOUTH COUNTY ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:DORSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-716-1900
Mailing Address - Street 1:25431 CABOT RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5526
Mailing Address - Country:US
Mailing Address - Phone:949-716-1900
Mailing Address - Fax:949-716-1919
Practice Address - Street 1:25431 CABOT RD STE 110
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5526
Practice Address - Country:US
Practice Address - Phone:949-716-1900
Practice Address - Fax:949-716-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG18078207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty