Provider Demographics
NPI:1659473171
Name:ORTHOPAEDIC ASSOC MEDICAL CLINIC, INC.
Entity Type:Organization
Organization Name:ORTHOPAEDIC ASSOC MEDICAL CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HINOJOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-733-3346
Mailing Address - Street 1:PO BOX 2632
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93279-2632
Mailing Address - Country:US
Mailing Address - Phone:559-625-0551
Mailing Address - Fax:559-733-4475
Practice Address - Street 1:820 S AKERS
Practice Address - Street 2:220
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-8309
Practice Address - Country:US
Practice Address - Phone:559-625-0551
Practice Address - Fax:559-733-4475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-04
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207X00000X
CAE5270213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ73838ZMedicare ID - Type Unspecified