Provider Demographics
NPI:1689624975
Name:ORTHOPEDIC ASSOCIATES MEDICAL GROUP
Entity Type:Organization
Organization Name:ORTHOPEDIC ASSOCIATES MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:ROTHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-698-0383
Mailing Address - Street 1:8135 PAINTER AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-3169
Mailing Address - Country:US
Mailing Address - Phone:562-698-0383
Mailing Address - Fax:562-693-6435
Practice Address - Street 1:8135 PAINTER AVE STE 300
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3169
Practice Address - Country:US
Practice Address - Phone:562-698-0383
Practice Address - Fax:562-693-6435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0048970Medicaid
CAW11414Medicare PIN
CA0242730001Medicare NSC
CAW11414Medicare ID - Type Unspecified
CAGR0048970Medicaid