Provider Demographics
NPI:1629320627
Name:WESTSIDE ORTHOPEDIC GROUP INC
Entity Type:Organization
Organization Name:WESTSIDE ORTHOPEDIC GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SCHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-483-4246
Mailing Address - Street 1:50 N LA CIENEGA BLVD
Mailing Address - Street 2:STE 203
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2227
Mailing Address - Country:US
Mailing Address - Phone:213-483-4246
Mailing Address - Fax:213-483-7257
Practice Address - Street 1:50 N LA CIENEGA BLVD
Practice Address - Street 2:STE 203
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2227
Practice Address - Country:US
Practice Address - Phone:213-483-4246
Practice Address - Fax:213-483-7257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty