Provider Demographics
NPI:1689003949
Name:ORTHOPEDIC ULTRASOUND, INC
Entity Type:Organization
Organization Name:ORTHOPEDIC ULTRASOUND, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:JABLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-330-1838
Mailing Address - Street 1:910 S EL CAMINO REAL
Mailing Address - Street 2:102
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-4279
Mailing Address - Country:US
Mailing Address - Phone:949-218-1943
Mailing Address - Fax:949-218-1946
Practice Address - Street 1:910 S EL CAMINO REAL
Practice Address - Street 2:102
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-4279
Practice Address - Country:US
Practice Address - Phone:949-218-1943
Practice Address - Fax:949-218-1946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty