Provider Demographics
NPI:1851409130
Name:ORTHOPAEDIC INSTITUTE MEDICAL GROUP INC
Entity Type:Organization
Organization Name:ORTHOPAEDIC INSTITUTE MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEUTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-542-3472
Mailing Address - Street 1:19000 HAWTHORNE BLVD
Mailing Address - Street 2:#100
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503
Mailing Address - Country:US
Mailing Address - Phone:310-542-3472
Mailing Address - Fax:310-542-8858
Practice Address - Street 1:19000 HAWTHORNE BLVD
Practice Address - Street 2:#100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:310-542-3472
Practice Address - Fax:310-542-8858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty