Provider Demographics
NPI:1770814030
Name:DR STEVEN SAMPSON MED CORP-GEN PTR OF ORTHOHEALING MED PTRSHIP
Entity Type:Organization
Organization Name:DR STEVEN SAMPSON MED CORP-GEN PTR OF ORTHOHEALING MED PTRSHIP
Other - Org Name:THE ORTHOHEALING CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-453-5404
Mailing Address - Street 1:10780 SANTA MONICA BLVD
Mailing Address - Street 2:#210
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4749
Mailing Address - Country:US
Mailing Address - Phone:310-453-5404
Mailing Address - Fax:310-453-2535
Practice Address - Street 1:10780 SANTA MONICA BLVD
Practice Address - Street 2:SUITE # 210
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4749
Practice Address - Country:US
Practice Address - Phone:310-453-5404
Practice Address - Fax:310-453-2535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty